Questionnaire & Booking Form

All information as well as the content of the session will of course be treated as strictly confidential. Please fill in all fields in both forms and then click on the „Submit“ button at the bottom of the page.

You will then receive an email with the binding confirmation of your session, which contains not only the essential contractual content (terms and conditions, price, payment modalities, etc.) but also instructions on how to withdraw.
The contract is only considered closed after receipt of this email.
If you do not receive this email within a week, please write an e-mail to us!
Both completed forms are saved by us and taken as a copy in the hand file. After the appointment, the saved appointment confirmation form is deleted within a week. You can inspect the copy of the form before the appointment to rule out any incorrect entries before starting treatment.
You can inspect the included general terms and conditions of Hypnos® at the end of the form before the binding confirmation of your information. You will receive this again with the confirmation email from Hypnos®. An online readable HTML version of the terms and conditions can be found here.
Please be aware that incorrect or incomplete information in this form would endanger the success of your therapy.
Incorrect or incomplete information can also lead to the therapeutic relationship not being achieved. We thank you for your care!