Electronic Forms                  760-415-3585                  KJLOFTIS@COX.NET

Below are electronic forms to complete and submit depending on what service you would like. The optional forms help me gather more information about you.  Please complete Electronic forms 24 hours prior to your appointment time.  If you have any questions, please do not hesitate to give me a call, text or email me.
​
Therapy Forms                                                        Optional Forms

Therapy Informed Consent (Required)                                                      Getting to Know You Form
(Please read & complete all pages--24 hours before your session)

Hypnotherapy Consent Form                                                                  Smoking Cessation    

Consent to Release Information                                                              Stress Level Profile

Consent to Treat Minor Child                                                               Weight Loss Questionnaire

Insurance Information                                                                         

Hypnotherapy Forms

Hypnotherapy Consent Form (Required)

Therapy Informed Consent  (Required)
(Please read & complete all 13 pages)

Relationship & Individual Coaching Forms

​Informed Consent for Coaching (Required)

Client Coaching Information (Required)



​
 
​