Take the Hallmark Assessment

This quick assessment to help determine if hypnotherapy is the right solution for you or if you need more guidance on improving your life and health. Please fill in your information below and click Next.

Full Name *

Email *

Phone *

Address

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? Feeling Nervous *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? Not being able to stop or control worrying *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? Worrying too much about different things *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? Trouble relaxing *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? Being so restless that it is hard to sit still *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? Becoming easily annoyed or irritable *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? Feeling afraid as if something awful might happen *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? I’ve been feeling optimistic about the future *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? I’ve been feeling useful *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? I’ve been feeling relaxed *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? I’ve been dealing with problems well *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? I’ve been thinking clearly *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? I’ve been feeling close to other people *

Not at all

Several Days

More than half the days

Nearly Every day

OVER THE LAST 2 WEEKS - How often have you been bothered by any of the following problems? I’ve been able to make up my own mind about things *

Not at all

Several Days

More than half the days

Nearly Every day