By taking just a few more moments you can share with Brad all the areas in your life you wish to improve easily utilizing the power of hypnosis. Once your information is submitted you will be able to schedule a free consultation with Brad and learn all the ways hypnosis can provide the changes you require and deserve. He’s looking forward to meeting you!

Name *

First Name

Last Name

Email *

Phone *

Country

(###)

###

####

What is your goal? *

Stop Smoking

Lose Weight

Release Anxiety

Overcome Fear

Eliminate Stress

Build Confidence

Learn about Hypnosis

Other

What have you done so far to address this? *

What's going to be different in your life as a result of achieving this goal? *

Whats been holding you back from making this change? *

How ready to change are you on a scale of 1 to 10? *

Why didn't you pick a lower number?

Why now? What motivated you to reach out today? *

How would you like to work with Brad: *

Online

Live

Combination

Are you ready to make an investment of time and money to achieve your personal best?

Yes, if necessary I would.

No, I'm not willing to.

Have you worked with a hypnotist before? *

Yes

What are the seven benefits you hope to gain by working with Brad? *Please make sure to include 7 benefits * *

Are you willing to experience uncomfortable emotions (temporarily) in order to release them fully, leading to the removal of your old outdated negative programming, habits, thoughts, compulsions, and behaviors? *

Please share any questions or notes you think I should know of in advance.

How did you hear about Brad Plotkin Hypnotherapy?

Google

Social Media

Friend, Family, or Referral

Stay in touch.

brad@bradplotkin.com

1200 West Ave. Miami Beach, FL 33139

Questions?

Book a Free Consultation Call

Results will always vary from person to person. However, we guarantee pristine service based on your specific needs, using the most advanced hypnotic techniques available. Hypnosis is not meant to diagnose and/or treat any diseases, but rather is intended to allow you to cope and heal, live your best live, and be a more effective YOU in any and every way.