Questionnaire 2 of 2

Personal Questionnaire 2 of 2

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Name *

First

Last

Email *

Why are you are you seeking support? *

How do you know you have this problem? *

How is that a problem? *

When do you do (not do) it? *

How do you do it? *

Can you do the problem now in your mind? How does it play out step by step *

Can you get in touch with the emotions as we you type and think about this *

How long have you been doing this? *

Was there ever a time when you didn't? *

What have you done about it? *

What happened the first time you had this? *

Were emotions were present? *

Do you ever feel positive/negative emotions? *

Have you heard that you have an Unconscious Mind? *

What events have happened since then? *

What emotions were present? *

In each. of these events, what is the relationship between the event and your current situation in life? *

Tell me about your parents, brothers, sisters, etc. *

What is the relationship between your mother and your current situation? *

What is the relationship between your father and your current situation? *

What is the relationship between your sister and your current situation? *

What is the relationship between (other family members) and your current situation? *

Tell me about your childhood in relationship to this problem? *

Is there a purpose for this problem? *

Is there a reason for having the problem? Ask your unconscious mind. "go with the flow, what comes up" *

When did you choose to have this situation be created? *

Why? Ask your unconscious mind. *

Is there anything your unconscious mind wants you to know, or is there anything you're not getting which, if you got it, would allow the problem to disappear? *

Is it OK with your unconscious mind to support us in removing this problem together, and for it to allow you to have an undeniable experience of it, when we are complete? *

How will you know when this problem has totally disappeared? *

So, when we get rid of ______ _, will the presenting problem totally disappear? *

What do you need to do that you don't want to do? *

What do you not want to do that you must? *

What is it about this problem that you cannot tell anyone? *

What is the relationship between this problem and problems you have in other areas of your life? *

Will any of those problems stop you from solving this problem? *

How will you know specifically that the problem is gone? *

Who did you model in youth? Relating to health / power/ protection? *

Who did you model your life on? *

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Personal Questionnaire 2 of 2

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"Believe, Achieve, Succeed"

Personal Questionnaire 2 of 2

ADDRESS

Telephone

​​Email

Response

LinkedIn

Skype

Facebook

Instagram

YouTube

"Believe, Achieve, Succeed"

Email