Changework Request Form

What are your hours and days of availability for the next two weeks for an appointment?
Please describe your current situation, and why that leads you to request a session.
Please describe your previous experience of trance or therapy if you have any (or other experience relevant to your request) What worked best, and what didn't seem to work so well?
Please describe what your goal is, i.e. what you want to get out of the sessions.
You've probably had this problem for a while, so why is it important enough for you to want to change now?
Please describe in concrete observable terms how you will know when you've reached your goal. How will you know you've gotten the result you wanted? What will others observe of you once you have changed? (if you want to stop doing something, or stop reacting in a certain way, specify what you will be doing or how you'll be reacting after the change) The reason for this question is that some people do therapy with vague goals, get vague results, and don't know when to stop. If you can't imagine concretely what you'll be like after the change, that means your goal was too vague. On the other hand, if you have concrete goal, we'll be able to judge your progress by your answer here.
Please describe your ideal therapist / counselor / guide. What kind of person are you looking for? Someone serious? Humorous? Detached? Empathetic?
Describe the limitations you want on your requests:- Limits, things you don't want - Phobias or allergies you may have
How do you feel about letting go and allowing someone else be in charge for a short time?
Are you living with other people?
Do you have children or other dependants who might need your immediate attention during a session ?
Do you currently have a sexual partner or spouse ?
What can you afford ?
If your session ends at a critical moment, and it would be better to continue a bit longer for better results (in trance, you probably won't be in a state to decide), would you agree to your session being prolonged by
How did you hear about me?
What is your wish? (the brief version of your request)
If you have not filled out all the sections, I will ask you to fill out the form again. Please do it right the first time. It is better to write more than not enough. By sending this, I freely agree to have the changework done as requested by Linda and I understand what that implies.