EmailMe Form - DIRECTORY LISTING APPLICATION

Your Name *
First Last
This will be the displayed name on your free directory listing.
It should ideally be the name on your most recent Hypnotherapy Qualification.
Your Business Name (if different)
EG: If your Hypnotherapy Clinic has a specific legal trading name such as: "Happy Hypno" or "Mary Jane's Hypnotherapy Services" then add that here.
If you simply trade under your own name, then please leave this field blank.
Location of your Hypnotherapy Practice *
Do you Conduct Online Consultations? *
No
Yes - What platform(s) do you use? (EG: SKYPE, ZOOM, etc.)
What is your Highest Hypnotherapy Training Course Qualification and Year? *
EG: HNZ Diploma in Advanced Clinical Hypnotherapy 2016
NB: Approved Training/Trainer conditions apply.
What Issues do you Provide HYPNOTHERAPY Support & Management for? *
You may add up to 10 issues.
1 issue per line - Short 1 or 2 word descriptions. EGs:
Weight
Smoking
Business Confidence
Sports Focus
(Long or inappropriately worded titles/descriptions may be deleted or edited in any listing provided.)

IMPORTANT NOTE: We adhere to ASA guidelines in our listings, so:
Do not add words such as: stop, improvement, better, success, fix, loss, or reduction to the issues that you list.
You must be able to scientifically justify any claims that you can improve any medical conditions.
Primary Phone Number
Additional Phone Number
Your Email *
Business Web Site
If you'd like us to show your website link in your free listing, we require a significant mention of Hypnotherapy New Zealand on a major page of your website that includes a prominent reciprocal link back to www.hypnotherapynewzealand.co.nz

The following link text should be placed on a major page of your website: "HYPNOTHERAPY NEW ZEALAND: Providing NZ Hypnotherapy Training, Support, Information & Resources Since 1996."
Business Facebook Page
If you'd like us to show your Hypnotherapy-business-specific (not personal) Facebook page as a link in your free listing, we require a significant mention of Hypnotherapy New Zealand on your Facebook Page "ABOUT" section, that includes a prominent reciprocal link back to www.hypnotherapynewzealand.co.nz

The following link text should be placed in the "ABOUT" section of your Facebook page: "HYPNOTHERAPY NEW ZEALAND: Providing NZ Hypnotherapy Training, Support, Information & Resources Since 1996."
Have you placed reciprocal links yet?
Yes: Facebook "About" Page
Yes: Website Major Page
Once we have confirmed your reciprocal link, we will include a bold link to your website within your free listing on our directory.
Do You Have Any Criminal Convictions? *
No
Yes
Upload a Recent Headshot *
Please use a .png or .jpg image that is already "square" or one that we can crop a suitable square from.
Upload a Copy of your Highest Hypnotherapy Training Certificate/Diploma Qualification.
NOTE: This is only required for those who have not trained with Grant Boddington.

Please use a .png or .jpg image format.

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