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Beyond Quantum Hypnosis Intake Form

Beyond Quantum Healing Client Intake Form and Information (Large portions of this document are directly or paraphrased from Candace Craw-Goldman at Quantum Healing, LLC and BQH) Thank you for booking a session with: Portalwithinhealing.com

What is your name?

What is your age?

What is your gender/pronoun?

What is the date and time of session?

What is your phone number?

What is your email?

How did you hear about Beyond Quantum healing?

How did you hear about my services?

What is the main reason you are seeking a BQH session?

Are there things that you are doing, feeling, thinking, or saying to yourself that you’d like to change? 

Have you experienced any type of formal hypnosis in the past?

If so, what was your experience like?

What are your intentions for the session? Please start thinking about this right away as we will discuss this before the session begins. Also note, it is important to start intending to have direct and clear communication with the part of you that will receive and give healing to the parts of you that desire that. Affirm this as Truth!

Prepare a List of Questions and Concerns 

Please come up with questions you would like to be addressed during the session. We will discuss these before the session and if any new questions pop up once we begin our session, we can add those as well. 


Put these questions and concerns in order of importance to you as we may not be able to address them all. I have had many clients bring a single question or issue of concern to the session, and some who bring dozens. It really does not matter how many you come up with, only that you put them in order of importance.

Responsibilities and Liability Release: 

1. I am willing to be guided through relaxation, visual imagery, hypnosis, and/or stress reduction techniques. I am aware these modalities are non-medical and it is my responsibility to consult my regular doctor about any changes in my condition or changes in my medication.

2. I understand the above modalities are not substitutes for regular medical care and I have been advised to consult my regular medical doctor or health-care practitioner for treatment of any old, new or existing medical conditions.

3. I understand that change is my own and complete responsibility. I understand that ALL HEALING IS SELF-HEALING and that Caroline Thomoff is only a “facilitator” in the process of helping me to solve my problem(s). It is my responsibility to be open and honest, provide accurate feedback and be forthcoming with details and information that may help me achieve my outcomes.

4. I understand the facilitator (Caroline Thomoff) may elect NOT to proceed with the session if she feels it is not in their or my best interest to do so.

5. I understand that our session will be recorded for my later use. I also understand that in these types of metaphysical sessions, the energy in the room can affect the equipment and recording resulting in static or blank recordings.

6. I agree to fully release and hold harmless Caroline Thomoff from and against any and all claims or liability of any nature arising out of, or in connection with my session(s).

Please sign that you agree to the responsibility and liability release

Signature

Please date the signature

Special Use of Information: 

I understand that my name and personal information will be kept completely confidential. 


I understand that I may share my recording and information in the future in any way that I am personally comfortable. 


I understand that often in BQH sessions, universal information is provided through the client to benefit all of humanity. I agree to allow Sage Smith to share this information and any accompanying story summary either in audio or video or in written form in blogs, articles, videos, speeches, or books as long as my identity, name, and all relevant personal details are omitted or changed. 

Please sign that you understand the special use of information:

Signature

Please date the signature

Preparing for a Quantum Healing/BQH Session It is up to you to decide how much you want to do to prepare for our session. In truth the most important and only requirement is to trust the process, and yourself and show up! But, many of you benefit greatly by learning to quiet the mind, reading some helpful articles to debunk myths and provide relevant information, and also by doing some practical things like practicing. Learn to Quiet your Mind If you are not a regular meditator now is the time to begin. A quiet mind that is not filled with racing or looping thoughts is your best asset in a BQH session. This is an excellent YouTube video that explains exactly what meditation is and why it is important. https://youtu.be/ZpCjZEikUGs Meditate in silence a minimum of 10-20 minutes per day or use the following YouTube nature sounds with headphones to help reduce outside noise interference. Forest Birds https://youtu.be/XxP8kxUn5bc Waterfall Sounds https://youtu.be/02NQkhbjALg Ocean Waves https://youtu.be/f77SKdyn-1Y Binaural Beats with music https://youtu.be/-OkCwjpeiBc Leave Expectations Behind! Intentions and expectations are completely different things. Specific expectations about what you are about to experience are not at all helpful. Also, why you may absolutely remember and “be present” for your entire experience. Here is a video Candace Craw-Goldman created with Dolores Cannon many years ago about expectations in any Quantum Healing session https://youtu.be/qcwI6411AY4 The What If? Imagination Game Listen to this link to familiarize yourself with my voice and to allow yourself the opportunity to practice using your imagination to visualize. https://www.dropbox.com/scl/fi/kk7hocbdsqio8d8a0t8lr/The-What-if-game.m4a?rlkey=e2nbioo9s6kbzg89j2f392uua&st=48cnaprc&dl=0 Common Hypnosis Myths Simply put, no, you will not simply go to sleep and wake up with all of your problems solved and no, it is not required that you go so deep into hypnosis that you become unconscious. Please read the following article about common misperceptions about regressions and hypnosis. https://www.quantumhealers.com/blog/i-cant-be-hypnotizedand-other-hypnosis-myths-61 Additional Preparation Information Here is a great article about how to prepare- with more article links embedded in that one. https://quantumhealers.com/nine-ways-to-prepare-for-a-quantum-healing-or-qhht-session-56/ Preparation on the Day and After the Session is Over Don’t drink alcoholic or caffeinated beverages before the session, or even, the evening before, if possible. If you are a regular morning coffee drinker, please don’t skip your coffee, but go easy and keep it to a minimum before your session. Light exercise prior to your appointment, like a long walk, is an excellent way to prepare for a successful session. This is another good time to repeat your intention. We want your body relaxed, but your mind quiet and alert and engaged. As much as possible, clear your day for the session. We begin by talking, going over the process and your questions. Find a quiet place to do the session where you can lie down comfortably, and have a glass of water nearby. Then you get comfortable and relaxed and we begin the actual hypnotic “regression.” We go over what was experienced, and we make sure you are awake and grounded for the rest of your day. It is generally not a good idea to have additional appointments after your session or plan a long drive ahead of you (unless you are in the passenger seat). Having a BQH session is very much like participating in a long, very detailed and involved daydream. You really will feel as if you have just returned from an amazing journey, having visited other worlds and lifetimes, and in fact, you will have done just exactly that. It is best to have some time to process your experience and give yourself an opportunity to fully return to your regular conscious day-to-day reality before attempting any complex mental tasks or strenuous physical activity.

If during the session you do get hungry or need to use the restroom please just let me know, it is a lot like just pushing pause on a movie. We can start again when you are ready and you may actually go deeper into the experience when you return. If at any point you feel uncomfortable with what you are experiencing, remember that you are always in control and you have the power to exit the scene or to let me know that you would like to move to a different scene. After our session I will prepare your digital recording and send either an MP3 file or a Zoom recording link to your selected email address. Please download your file as soon as you receive the link and make a backup copy. I cannot archive your recording indefinitely. Listening to your session in the days and weeks and even months ahead can be a very valuable component of your BQH session. Even if your conscious mind “remembers” the session immediately afterwards, it can, just as some dreams can, begin to fade from your memory, even if you had an “unforgettable” experience! In addition, further energetic downloads of information may be enhanced by repeat listening. Also, any healing or life improvement suggestions can and will be reinforced by listening repeatedly to the audio. One goal of quantum healing is to have your conscious mind “get on board” and align with your Higher Self and its goals and accept any changes or healing you intend to occur. Technical Information Online sessions are held using Zoom, an easy web-based video meeting system. Having a headset or ear buds with microphone attached available is important. Though, if you do not have that we can work around that, I just need to make sure I can hear you during the session. I will send you a personalized LINK for our session appointment. Please practice using Zoom and test out all of your equipment and your internet connection with a friend BEFORE our session! You will not want to spend our valuable session time focusing on your equipment.

Payment 

Both Online and in person sessions can be paid via Venmo, Zelle, PayPal or Transfer Wise. For in person sessions you may bring cash! 


Note: 

Online Sessions require prepayment before we begin the session. 


Cancellation fees may be charged. 

Appointments must be canceled at least 24 hours in advance. If an appointment is canceled with less than 24 hours notice, and I am able to fill that appointment, there will be no charge. If not, there will be no charge the first time. After that, the normal fee will be charged. 


If an appointment is forgotten (a client does not come or call) there will be no charge for the first visit. After that, the normal fee will be charged.  


Late Policy: 

Upon notice, I am willing to wait for up to 15 minutes after the starting time of your appointment. If you are late, your session may be shortened in order to accommodate others whose appointments follow yours. Regardless of the length of the treatment actually given, you will be financially responsible for the full session. If you do not give notice of you running late, your appointment may be cancelled. If you arrive past the 15 minute grace period, your appointment will be cancelled. 


I understand that you are human and unanticipated events happen. My goal is to work with you in the most compassionate way. 

Please sign that you agree to the payment and cancellation policy

Signature

Please date the signature

Finally, remember that I am always interested in hearing from you in the future and encourage you to send me a message or leave feedback on my review page and let me know how the BQH session has affected your life.

With love, 

Caroline