Client Intake Form

Soul Vibes Client Intake Form

I am Kristie Hidrogo – your empowering, soul connecting Mindset Coach & Hypnotherapist! I am thrilled for the opportunity to work with you!

My sessions are approximately 60-90 minutes at a per session cost of $175. View pricing and packages HERE.
Please know:

– I will create a sacred, safe space where information shared during sessions is kept private and confidential.
– I am NOT a professional therapist or psychotherapist.
– Sessions are a blend of mindset coaching & hypnotherapy.
– This collaborative process with help guide you to powerful discovery, empower you to create change, and create purposeful & fulfilling expansion.

Before embarking on this beautiful journey within, consider your commitment to me and promise to yourself:

– I am committed to participating during sessions for maximum benefit.
– I will be honest with myself and Kristie.
– I will take 100% responsibility for my actions and healing.
– I will keep my agreements.

All personal information is confidential and treated appropriately.

Responsibilities (Please Acknowledge)

I understand that coaching is not advice - giving, psychotherapy or counseling. I agree to these or other professional services, if needed.
I am fully responsible for the decisions and actions I take regarding my life and affairs.
I agree to be mindful of my own well-being during our coaching & hypnotherapy sessions.
I shall in no way, hold Kristie Hidrogo Mindset Coach & Hypnotherapist liable or responsible for any actions during or after our coaching sessions, hypnosis sessions or duration of coaching relationship.

Your Name

Your Email

Your Phone

Your Date of Birth

Partnership Status

Emergency Contact

Occupation

Referral Source

Reason for engaging coaching or hypnotherapy services

As a mindset coach, it’s important for me to understand how you view the world in general and yourself in particular. Each person has a unique way of thinking and a unique way of interacting with those around him or her.
Answer each of these questions as clearly and thoughtfully as possible, expressing the best of who you are. These are “pondering” questions designed to stimulate your thinking in a particular way that will make our work together even more productive.

What accomplishments must, in your opinion, occur during your lifetime so that you will consider your life to have been satisfying and well lived — a life of few or no regrets?

If there were a secret passion in your life, what would it be?

If you trusted your coach enough to tell him or her how to manage you most effectively, what tips would you give?

What’s missing in your life? What would make your life more fulfilling?

Do you believe in God or in the concept of a higher power? If so, describe the most useful and empowering aspects of your relationship with God. If not, what reference point do you use?

As your coach is there anything else you would like me to know about you?

Hypnotherapy Questionnaire

What do you hope to achieve with hypnotherapy?

Have you been hypnotized before? Do you feel it was successful, why or why not?

Do you find that you have an analytical mind?

Do you consider yourself a visual person?

If you could imagine your favorite place to relax (beach, woods, at home, garden, etc), where would it be?

Is there anything specific you do now to relax?

Do you have any underlying health conditions I should be made aware of?

Do you drink caffeine (what is your caffeine intake)?

* Refund Policy *

Packages: By completion of the 2nd session (as it pertains to any package purchased), should the client wish to discontinue coaching services, verbal or written notice must be provided to the coach. Remainder of funds will be refunded back to the client.

* Cancellation Policy *

Packages: Notice must be provided 3 hours prior to start of session. Session can then be rescheduled. Failure to provide notice of cancellation can lead to loss of single session within package.

By signing below, I acknowledge that I have had the opportunity to review this agreement, and that I understand all aspects within it, and I agree to abide by it.

* Contact Policy *

Communication shall be conducted during normal working hours:
Monday – Friday
Hours – 9am – 5pm
Any questions asked between sessions via text or over the phone, shall be reserved for session time only. Coaching sessions will not be conducted via text.