Congratulations on your decision to be a non smoker!

At Clear Intentions Hypnosis I want you to feel comfortable with your decision.  Our work together is  a partnership that will allow this change to happen for you more easily than you imagined.  Below is some information and some homework for you to complete before your appointment. 

This is a big decision and I want to make sure your mind is prepared properly for this change to occur. Please take your time while doing the homework, it will make your session more effective.  If at anytime you have any questions please email me. This is about you and I want to do everything I can to ensure your success.

Please fill out and submit this form before your next appointment.

If at anytime you have any questions please email me. This is about you and I want to do everything I can to ensure your success. I look forward to working with you!

Welcome to Clear Intentions Hypnosis. I do my very best to ensure that I provide the highest quality hypnosis services available. I do this by constantly improving my techniques and keeping up with the latest developments in the field of hypnosis. I am certified as a Hypnotherapist by the National Guild of Hypnotists and practice in accordance with its Code of Ethics and Standards. I am also a Board Certified Coach through the Center of Credentialing and Education.

My Approach: I sincerely believe that we harness incredible untapped power within our minds. Our practice of hypnosis is designed to tap into that power and assist people in using that power to better their lives. I often use a combination of hypnosis, NLP (Neural Linguistic Programming), brain retraining and Life Coaching techniques. I am not a “medical” or “psychological” professional.

As one might expect, there is some variation in the length of sessions. I try to keep to a strict schedule, but sometimes I may run late. Please note that if I am running late that it is usually for a good reason. One based on the needs of my client.

As the Client, you will:

  • Arrive for your sessions on time and prepared for a great session.
  • Give me at least 24 hours notice if I need to reschedule our appointment.
  • Be open to new ideas and approaches.
  • Share feedback with me and always be as honest as you can.

As the hypnotist/Coach, I will:

  • Provide guidance towards the Client’s development of their personal or business needs.
  • Give the Client 24 hours notice if the schedule needs to change.
  • Arrive on time and ready for a great session.
  • Maintain all personal and proprietary business matters discussed in strict confidence.

Confidentiality:  I will not release any information to anyone without a written authorization from you, except as provided for by law.

Lastly, hypnosis is a very powerful process that has helped thousands of Americans make the kinds of changes that they want to make in their lives. However, hypnosis is not mind control.  For example, no one, not even the very best hypnotist, could make you lose weight, or stop smoking if you really don’t want to. Nor could he or she accurately predict how many sessions it will take. Most people (but not everyone) begin to experience the benefits from the very first session and most people are finished in three to five sessions and some choose to come for a “tune up” every 6 months to a year. Ultimately, you are responsible for the changes that occur as a result of the hypnosis sessions. What I can guarantee, here at Clear Intentions Hypnosis, is the very best service, using current information and appropriate hypnotic techniques for your situation.

Congratulations on taking action that sets you apart from the masses!

Client History Form

Please fill out this form and bring it to your appointment.

Hypnosis  Smoking Homework

1) On a piece of paper that will fit into the sleeve of your pack make a list of all of the things that you HATE or dislike about smoking. Example: yellow teeth, bad breath, smell, cost, cough, low energy, etc. Put it in the sleeve of your pack and read and remind yourself of it before you light up.

2)    Make another list of all the benefits that you’ll receive as a non-smoker and put that list on the other side of your pack and read it when you’re done smoking. (bring both of these lists with you)

3)    Get a calculator and figure out how much money you’ve spent on cigarettes and cigarette related illness since you started smoking. Then make a list of 3 things you would have rather spent that money on.

4)    Have your last cigarette within 24 hours to your session and announce to yourself and to that cigarette that it is your last. E.g. “This is my last cigarette. I am now a nonsmoker and will be a nonsmoker for the rest of my life. Cigarettes you are no longer in control of me. I’m in control of me – my thoughts, my actions, my health and my money. I am a NON SMOKER!!!!”

5) As soon as you read this I want you to mindfully smoke for 4 days. What does that mean? I want you to focus completely on smoking, what are you feeling? what does it taste like? How does it make you feel? Are you enjoying it? Get curious what else do you notice? Write those observations down.

6)     After you have done the mindfulness smoking for 4 days then I want you to smoke with the opposite hand that you usually smoke with before your appointment. I want this to feel uncomfortable.  This will create awareness and start making it uncomfortable.

7)     Write down a list of when and where and with whom you typically smoke.  These are your triggers.

8) Write why it is important for you to quit NOW

9)      Bring your homework and any remaining cigarettes or lighters with you when you come. You will be a non-smoker when you leave the center. Congratulations!!

10) Please click and download this file to read: 


12) If you would like, watch a client talk about their experience: