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Tailored Mp3 Order Form

Place your order now from only £35!

First Name

Last Name

Preferred name

Email

Phone

Any other information?

Noises/Distractions at bedtime

Dog

Cats

Neighbours

Passers by

Distant traffic

Partner snoring

Washing machine

Pipes

Clock

Others - please provide info in box below

Track Focus (4 maximum)

Self-Belief

Let go of the past

Feel in control

Less Stressed/Calmer

Being Decisive/Trusting your decisions

Sleep Well

Positive thinking

Less pressure on yourself/allowing mistakes

Feeling Empowered

Setting Boundaries

Goal setting and achieving

Overcome anxiety

Stop being easily influenced/Be me

Positive thinking/mindset

Change my persepective

Anger Management

Find work/life Balance

More Productive

If I could go anywhere to relax alone it would be...

At home

In a Garden

Hotel/Manor House

Tropical Island

Forest/Woodlands

Other (please provide more info)

Sounds I find relaxing

Rain sounds

Bird song

All the sounds of nature

Waves

Piano

Stringed instuments

Flute

Other - please provide info

No preference

Do you have a specific goal for the next 12 months? Please provide more info

Request submitted. Please allow 28 Days to recieve your audio.

Therapist: Laura Cullingford
Hypnotherapist and Psychotherapist
Swindon, Wiltshire

Tel: 07510652217
Email: laura@hypnotherapywithlaura.com

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