Forms -

Options for the forms below.

1. Open the forms in Adobe Reader, fill them out and tap the SUBMIT button to send directly. If you do not have Adobe Reader you may download it HERE. (The SUBMIT button will only work in Adobe Reader)

2. Open the forms in your browser, fill out the form, then download to your computer, attach to an email from you to Jeri at jhh1261@yahoo.com and send as an attachment.

3. Print forms, fill them out and bring with you at your appointment.

Jeri-Client-Intake-Form

Hypnotherapy facts

Hypnotherapy Consent Form

Authorization-for-Release-of-Information

Cancellation policy

Current-Procedure-Terminology-Code

Limit of Confidentially

Notice-Of-Privacy-Practices-Form

JS Privacy-Policy

Your Rights

Please download, read, fill out the "This is YOUR Life form and either submit to Jeri or bring with Intake Forms.