Documents and Forms - Columbus Hypnosis Center

Fill out before your first visit

After you book your visit with a hypnotist or hypnotherapist, please fill out the paperwork below and bring it with you to the first visit. If you do not fill out the information before the first visit we cannot complete your session. Paperwork may be filled out in the first session, but this will reduce the time for your session and you will be billed at the full session price.

Children are not permitted to be left in the welcome area alone. If your child(ren) are not scheduled for an appointment, we ask that you leave them with a childcare provider in an alternative location, so that we might best serve our clients, including you.

Minors will need a parent or guardian present at the first session to fill out authorizations for treatment. Your counselor will instruct you as to their desire for your presence at the sessions that follow.

**There is a fee of $75 for any appointments that are canceled within less than 24 hours for a non-emergency and for any sessions that are not attended without a previously made phone call (no call no show).

Suggestibility questionnaire
Smoking Survey
Credit card form
Personal information
Acknowledgement of services
Life history questionnaire
Informed consent
Privacy notice
Request for Therapy Referral

Yvonne is a skilled professional! I lost an item and needed her services to help locate it. I definitely recommend Columbus Hypnosis Center.

Felice

Yvonne is obviously a very experienced and skilled therapist. I have had a great experience with her and her practice!

Alyssa M.

I worked with Mahkayla and she has helped me be less anxious and nervous, especially while driving. She made me very comfortable, and is so sweet! I will definitely be going back

Natalie R.

Yvonne Judge is so skilled and competent and appreciated learning I used smoking to relax – check out and the reason exercising didn’t replace my need bec it was the opposite effect.
A smoker (again) after a cold turkey stop nearly 20 years ago and started again 5 years ago during an awful period in my life. I found I liked smoking too much or perhaps having frequent “time outs” in my day and didn’t want to part ways. Fact was I couldn’t ever afford smoking W today’s prices and was getting harder for me to find money to buy them, the impact on my health sometimes too noticeable, the too early for my age wrinkles under my eyes, I knew came from smoking and Worst of All, Feelings of Powerlessness to …cigarettes?!

Tried every alternative: patches, gum, exercise etc and nothing helped.

I researched hypnosis vs hypnotherapy and based on positive reviews of Yvonne, I gave it A try.
***understand, before we began, I wanted so badly to run out and have one “last” one…ummm, that didn’t happen and felt antsy but as we started I felt relaxed and the fidgetiness gone…went to 2/3 appointments and around 3+months felt the want creeping in but realized “no way- I actually don’t want it”.
I recommend completing all 3 sessions as prescribed and I’m now going to finish.
I again feel empowered and strong!

Dina J.

I recently started seeing Yvonne Judge for hypnosis. She is professional and immediately put me at ease. She has a calming voice and presence that allowed me to relax and undergo hypnosis. I have learned relaxation techniques to help relieve stress in my life. I am happy that I have taken this step with her.

Jody J.

I suffered from a few issues that I knew needed to be adjusted and hearing about hypnotherapy, decided to give it a try. Yvonne Judge was my therapist and while we only worked for a few months, I felt an overwhelming need to complete a novel, and improve my writing skills (and still do). She also assisted me in accepting other personal aspects, that has relieved my stress levels. I am glad I gave it a try.

Tony P.