Request A Call – 1st Choice Hypnosis

Name *

First

Last

City & State of residence *

Briefly describe how I may be of assistance to you? *

(Optional) Do you have any specific questions?

*NOTE* - Pricing will ONLY be quoted during a live consultation because too many factors are involved to give you a "blanket amount" without knowing your specific details.

Viable Email Address *

*please be mindful of also checking your spam-folder, incase your server transfers my email there, rather than directly to you inbox.

Reliable Phone Number *

NOTE: A cellphone number which accepts voicemail and text messaging is preferred.

Which time frame is best for you to be available to take my call? *

Tue - Fri, 4pm - 8pm
Saturday, at my earliest convenience (10am - 9pm)
I prefer to be contacted via text messages at the above noted phone number, Mon - Fri., 11am - 9pm
I am only available to take calls on Sundays - from 1pm - 8pm

Consultation agreement *

I agree

Every attempt will be made to reach you during the time frame you have indicated above. However, due to my workload or other extenuating circumstances, there may be times when doing so simply is not possible. If such is the case, you hereby agree to be contacted via email or other method available to me, Eva Wells, at my earliest convenience. If you do you not reply/answer, I will try one other time, at my earliest convenience, to reach you. If you do not reply/answer upon my 2nd attempt to contact you, to continue further interactions, you will be required to contact me via direct email at eva@1stchoicehyposis.com OR text message at (937) 315-2730 and understand that my reply may or may not be delayed, however, I WILL reply to all messages received as soon as possible.

Partnership Agreement *

I agree

As a professional, it is my obligation and right to decide who is the best match for the services that I offer. This is an integral and mandatory part of the consultation process. Because my services are directed at providing my clients with the very best results, it is imperative that personality, open communication, friendliness, courteousness, respect, and commitment to success are highly evaluated at all times. Therefore, and although it is rare, if for any reason that I feel that you would not be a good candidate to work with, I reserve all rights and will not hesitate to promptly end all communications with you. If such is the case, and if you request it, I would be happy to refer you to other colleagues who may be able to assist you.

Cancellation Policy *

I agree

Consultations are done over the phone, only, and are free of charge. The moment you schedule a session with me, you are my top priority. I commit 100% to following through with our agreement. Therefore, once you establish an appointment for a session, it is your responsibility to commit to that appointment time. I take my time, and yours, seriously. While I understand that things do happen at times, I ask you to also understand that in order for this to happen, I incur expenses and overhead so that I can be fully available for you. For that reason, if you do not call with a minimum of a 4 hour notice, or if you do not show up for your appointment, you will forfeit that session or will be charged the full cost of a single session price. If you do call to cancel or reschedule with a minimum of LESS THAN a 4 hour notice, you will be charged $75.00 or will forfeit half of your next session hour. *These terms are non-negotiable. Thank you. E.Wells, CPHi, CMCL @ 1st Choice Hypnosis 937-315-2730 (text or call)

Which payment option are you interested in? *

Credit Card
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Pre-Authorized Automated Electronic Payment Arrangements: structured at a 50% deposit upfront with concurring payments of remaining balance to be divided equally into your remaining sessions

**NOTE** - I do not work with billing any Health Insurance companies. If you need to apply your insurance benefits, you will need to seek the assistance of a Licensed Psychiatrist or Psychologist.