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Medical Referral Form For Hypnosis

Dear Doctor,

If your patient is willing to try hypnosis then please refer your patient to me.  I can help your patient relax and feel better using individual self-hypnotic techniques.  We, the consulting hypnotists, use hypnotic trance and suggestion to adjust habits of thought, feeling and behavior. You should think of me as a complementary care provider helping doctors treat some of their patients more effectively.

I will send you my report about your patient’s success (if any) after a session.

I can be easily contacted by phone: (646) 630-2173 or via email: alexandre.ivlev@gmail.com 

Sincerely,

Alexander Ivlev, a certified hypnotist.

 To print a referral form please click the blue link down here:

Medical Referral Form