Appointment Request This form enables you to submit a quick request for an appointment. Name: * Phone Number * Email Address * Is this your first appointment? *   Yes    No  Please list the objective of the appointment. Please list three preferred appointment times. I will do my best to accommodate you at one of these times. How did you hear about Rob Hadley and Vancouver Hypnotherapy? Would you be prepared to pay a $50 additional fee for your appointment if you were able to be slotted in during the next 48 hours?   Yes - it's important I see you urgently!    No - thanks.  * = Input is required

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