BOOK To Book a Session, Please Call or Text Jasmyn Call (609)741-6669 Text (609)741-6669 To Get the Most out of Your session, Please Fill in the Form Name(Required) First Last Email(Required) Date of Birth(Required) MM slash DD slash YYYY Phone(Required)Relationship Status(Required) Single Married Widowed Other Any health problem or concerns? (past or present)From the list below click your area of concern: Addictions Drinking Smoking Drugs Gambling From the list below click your area of concern: Anxiety Stress Fears Phobia Guilt Relaxation From the list below click your area of concern: Eating Food/Diet Weight Problems Anorexia Bulimia Exercise From the list below click your area of concern: Depression Confidence Motivation Procrastination Achieving Goals From the list below click your area of concern: Sexual Problems Fertility IVF Conception Pregnancy Birth From the list below click your area of concern: Hearing Sight/Vision Mobility Skin Hair Growth From the list below click your area of concern: Relationship Childhood Problems Sleep Problems What are your presenting problems?In detail, what was your childhood like?Are your presenting problems holding you back? If so, In what ways?What are your triggers/patterns/ habits?Imagining life without the problem, what would be possible for you? (descriptive details)How would you present yourself if the problem no longer existed?If I could wave a magic wand and grant you one wish, what would that wish be and why?Closing your eyes imagine yourself 1 year from now. How would this new version of you act? How would present yourself?What would your daily routine look like?Is there anything else you feel is important for me to know for our session?
