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Adventure Hypnosis Request Form

no mature content

Please Install Yahoo Instant Messenger BEFORE filling out the form
I file requests by Yahoo nickname
If a form does not have an Yahoo ID nickname it gets thrown into The Pile.


This form is not working, please email me if you want a session.

Your E-mail Address:
Your Name:
What is your age?
What is your birthday? (optional)

What is your gender:

Male Female Transgendered

What is your education:
What is your occupation?

What state/province are you in?
(or country if outside of North America)

What time zone are you in? (I am in EST)

Describe the adventure you want

Be as explicit as possible.

Storyline for Fantasy Adventures

A good story has a genre, so if you're wanting a fantasy adventure, please select all the genres that apply to your story:


Action (explosions, car chases, martial arts)
Adventure (heroes and villains)
Disaster / Survival
Espionage (spies)
Horror (zombies, ghosts, evil spells)
Road movie (a quest or escape)
Sports (cheerleading, team sports, etc.)

Animated (cartoons, anime, furries)
Slapstick Comedy (cartoonish exageration)
Dark Comedy (Adams Family, Shaun of the Dead)
Science Fiction
Drama (bad things happen to good people)
Melodrama (weepers, crying chick flicks)
Musical (only really works for phone sessions)

Are we leaning more towards:

Chick Flick (Emotions, Relationships, Drama)
Guy Flicks (Action, Sex, Violence)
A mix of both

Setting for the Story

Historical (pick a period of history)
Western (cowboys & outlaws)
Retro (within the last hundred years)
Alternate universe

Rules of the universe

Are there sex change machines or spells?
Realistic (it could happen in real life)
Improbable (possible but unlikely)
Action Hero (the hero can't die)
Fantasy (magic, elves, witches, vampires)
Science Fiction (mad scientists, ray guns)
Unknown (everything seems normal, but is it?)
Surreal (art films, like dreams, don't necessarily make sense)

Premise of the story

The premise of a story is the initial situation that generates the plot. This is what you'd read in the TV Guide, the initial situation for a TV show. It doesn't reveal everything, which is the point, and gives opportunities for the viewer to be surprised by the story. I'm going to give a long list of examples, so you can pick one, or make your own.

Click here to open a new window with a list of examples

So, what's the premise of your story?

Describe your previous experience

Please describe your previous experience of trance or therapy if you have any (or other experience relevant to your request)
What worked best, and what didn't seem to work so well?

Please try the Hypno Quiz and report the results (the link will open a new window)
(Yes, try the HypnoQuiz NOW, I want to know the results)

Hypno Quiz

Session extension

Especially during the first session, the end of the hour may come at a critical moment, and it would be better to continue a bit longer for better results.

Knowing you would then pay for additional time...

I don't want my session prolonged without being awakened and asked first
I agree that my session can be prolonged by 15 minutes
I agree that my session can be prolonged by 30 minutes
I agree that my session can be prolonged by 60 minutes
I agree that my session can be prolonged by as much as my hypnotist sees fit.

Online Chat software

is my Yahoo Instant Messenger ID (preferred)
is my MSN Messenger / Windows Messenger screen name

The operating software on my computer is
(Vista WinXP, NT, WinME, Win98, Win95, Win3.1, MacOS, Linux,...)


What is your availability for the next two weeks?

(if you are ready to have a session now)

How do you feel about letting go

and allowing someone else be in charge for a short time? Some amount of this is necessary for trance.

No problem, I can easily let someone else take over for a while
I can let someone else be in charge for a while if there's a good reason
I'd really rather be in control. I find it difficult to let go.
I need to always be in total control of what's going on. I never let go.

Please describe your ideal hypnotist

What kind of person are you looking for? Someone serious? Humorous? Detached? Empathic?

Describe the limitations you want on your requests:

- Limits, things you don't want
- Phobias or allergies you may have

Are you living with other people? Yes No
Do you have children or other dependants who might need your immediate attention during a session ? Yes No
Do you currently have a sexual partner or spouse ? Yes No

Where did you hear
about this website ?

(if you did a search on search engines, I would like to know what you wrote in the search box to find me)

What can you afford ?

Regular in person sessions
(first session must be online or by phone to prove you are serious)
Occasional in person sessions
Regular phone sessions
Occasional phone sessions
Regular online sessions
Occasional online sessions
Just one session if I save up
I can't afford anything... pretty please?

What is your wish?

(the brief version of your request)


If you have not filled out every section, I will ask you to fill out the form again. Please do it right the first time.

It is better to write more than not enough.

By clicking here, I freely agree to have the adventure hypnosis done as requested by Linda and I understand what that implies



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