1. What is your name?

2. Your address please?

3. You telephone number?

4. Your date of birth?

5. What's their problem?

6. How long have you had this problem?

7. How do you feel this problem started?

8. What do you feel I need to do for you today to permanently cure this problem?

9. What is the final outcome you wish to achieve from today?

10. What was the best experience of you entire life, a time you felt confident, proud, loved and on top of the world?

11. What was the worst and most emotionally painful experience of your entire life?

12. Who's the one person you love most in the entire world?

13. Are you on any medication for this problem?

14. Is there a history of this problem within your direct family?

15. Have you tried any other alternative therapies to cure this problem before?

16. Have you got any questions for me before we begin?

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