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450 W Wilson Bridge Road, Suite 350, Worthington, OH 43085
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Columbus Hypnosis Center
Hypnotherapy in Columbus, Ohio
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Home
About
About
Services
Forms
Hypnosis FAQ
Good Faith Estimates
Articles
Media
Contact Us
Are you ready to quit smoking?
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Are you ready to quit…
Are you ready to quit smoking?
Why do you want to quit smoking?
Personal reasons such as health and energy
A loved one wants me to quit
Not sure
Do you really want to quit smoking?
Yes, absolutely!
Sort of, but I need to.
No, but I'm told I should.
How many cigarettes do you smoke each day?
1-10
10-20
1-2 packs
More than 2 packs
Do you smoke your cigarettes all the way down?
Yes
No
Do you smoke regular or light cigarettes?
Regular
Light
What brand of cigarettes do you smoke?
What age did you start smoking?
Have you stopped smoking before and started back up?
Yes
No
If you stopped smoking before, how did you stop?
If you stopped smoking before, was it easy or difficult?
Easy
Difficult
What made you start smoking again when you had quit before?
When do you usually smoke?
What are your smoking triggers? (i.e. with coffee, before bed)
What do you like about smoking?
What do you dislike about smoking?
Do you have any fears about stopping smoking?
Are there times you can go for many hours without smoking and it doesn't bother you?
Yes
No
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