Questionnaire: Fill in before the session Your full name(required) E-post(required) I have read the information letter and am aware of the information contained there. I am aware that cancellations closer than 3 days before the session will be charged.(required) I'm aware that according to law only doctor's are allowed to say that they treat or cure diseases and that Boel does not give promises like that.(required) I am aware that Boel cannot guarantee results, as everything we do is teamwork and that no therapist can succeed with everyone all the time! (However, Boel is of course doing her ULTIMATE to help you achieve the best results possible!)(required) Would you like to pay with Swish (123 419 37 93) or to Bankgiro 257-1156? You get a receipt when we meet up, so the money has to be shown on my account when we meet up. If you have your own business the price is ex. moms. Bankgiro Swish Describe with a maximum of a few sentences what you would like me to help you with!(required) What does your dream scenario look like? How would you LIKE to feel or act? For how long have you had the problem? Do you know what triggered/caused the problem to begin with? In what types of situations do you notice the problems the most? Has the problem contributed to any positive effects? (For example, if you can blame the problem for not being able to do things that you don't want to do anyway, it can subconsciously affect your desire to get rid of it negatively.) What have you done so far to try to get rid of the problem and if so, has it helped? Are you currently taking any medicines/vitamins/dietary supplements/herbal preparations? If so, write down the strength and brand! I often have headaches/migraines I wake up easily at night I have difficulty falling asleep I have a hard time unwinding after work I often have muscle pain/muscle tension I get tendon pulls/cramps in my calves/feet sometimes in the evenings/nights I get tired or depressed almost as soon as the summer is over I get tired or depressed in the winter I usually get tired/depressed around March/April/May I often catch a cold I have a great need to add a lot of salt to my food I have poor digestion I see disaster scenarios in my head related to the problem I want help with Read the list of fears below and mark which fears you think you have a problem with. Also tick the box if you only feel that specific fear SOMETIMES in CERTAIN situations I'm afraid of being rejected/feeling left out. Or often feel that I don't fit in I often feel inferior (that I am not as good as other people) I fear not being in control/feeling powerless/helpless I'm afraid of not being loved I'm afraid of feeling abandoned I'm afraid of feeling stupid/dismissed/ashamed/coming across as a fraud I often take the blame, carry a lot of guilt I find it hard to take responsibility when I've done wrong, and often say it was someone else's fault Afraid of not being significant/important I am often afraid of being let down, cheated or disappointed I am afraid of letting others down I feel unfairly treated I hate it when people try to control me I am afraid of feeling like a burden to others I often feel inadequate or like a failure Which of the fears above torments you the most?(required) Have you ever felt close to death? (for example, been close to drowning, experienced food stuck in your throat and you couldn't breathe, etc.) Do you have any siblings? And in that case are you the oldest/youngest/middle child? How much younger/older are you than the others? Did you have a good/bad relationship with them growing up? (if you have siblings) How did your father treat you when you grew up? (if you had a father) Did he have high expectations of you? Select one option Yes No Did you feel loved by him? How did your mother treat you when you grew up? Did she have high expectations of you? Select one option Yes No Would you say you have a more scientific or a more spiritual/religious view of life and death (or a mix)? (The question helps me to be better able to meet you based on your point of view!) Name very briefly 3 difficult events that affected you negatively when you were growing up BEFORE you were 20 years old. Write in a maximum of one sentence what happened, how old you were and how it made you feel. Event nr 2. What happened, how old were you and how did it make you feel? Event nr 3. What happened, how old were you and how did it make you feel? Anything else that you think is important to mention? For example if you have some kind of fear regarding the hypnosis itself that is good for me to be aware of in order to help you better? And lastly…..how come you chose to come to me in particular? Send! Δ Dela gärna min sida:Klicka för att dela på Facebook (Öppnas i ett nytt fönster)Klicka för att dela via LinkedIn (Öppnas i ett nytt fönster)Klicka för att dela på X (Öppnas i ett nytt fönster)
Viability - Hypnos, näringsmedicin och gentest 