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  • Date of Birth*
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    2 digit day, 2 digit month, 4 digit year
  • Phone
  • What are you intested in?*
  • Current issues (choose all that applies)
  • How close of you feel to achiving this goal?*
  • How ready are you to make changes toward this goal?*
  • Do you have any of the following conditions: i) epilepsy or a history of seizures, ii) psychotic disorders, e.g., schizophrenia, iii) severe mental health conditions needing medical supervision, or iv) certain heart conditions where deep relaxation isn’t advised?*

  • ⚠️ Unfortunately, RTT may not be suitable for you at this time

    Thank you for your honesty in completing the form. To ensure your safety and wellbeing, certain health conditions require specialist support before engaging in sessions that involve deep relaxation or subconscious work—like Rapid Transformational Therapy (RTT) or hypnosis.

    Based on your response, it's important that we pause here and do not proceed with RTT or hypnosis-based services at this time.

    🧡 But we can still work together

    If you're navigating challenges and still want guidance, I offer coaching sessions that do not involve hypnosis. These can be a powerful alternative for inner work, mindset transformation, and emotional support—tailored to your needs.

    If you're unsure about your situation or would like to explore what support might be right for you, please reach out to me via email: hello@yingyingsu.com

  • Are you currently taking any prescription medications?*
  • Emergency contact phone number
  • Have you worked with a coach or therapist before?
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