Past Life Regression Intake Form

A past life regression session can bring you invaluable insights because it will help to provide you with the key understanding of how you are ‘holding on’ to emotional patterns in this life that stem from old wounds accumulated during prior lifetimes.

Complete Form

Past Life Regression (PLR) is a gentle form of hypnotherapy that helps individuals discover specific information about their past lives. Many people have memories and experiences buried in the subconscious mind that most do not remember completely. A PLR session enables one to enter a state of hypnosis to access these memories and harness them for help in gaining deeper understanding of oneself and the purpose of one’s existence, with regards to the present life and inner development.

Past life regression is a practice often an under-utilized method for helping people identify beneficial past life influences and experience them in the present life, which can help with a wide range of issues affecting both their relationships and career path. For example, many people use it to overcome difficulties that have been carried forward from traumatic childhoods or heal complicated relationship dynamics. This helps to bring anyone back down to square one where people feel empowered, hopeful, optimistic and genuinely excited about who they really are and what they’re meant to be doing in this lifetime. It also helps you analyze situations in order to figure out ways you can overcome certain hurdles in your overall well being by taking full advantage of positive experiences that occurred prior as well!

Trauma and issues from the past can be easily reactivated by events in our current lifetime without our conscious awareness. We might react to people and situations in ways that seem counter-productive, or we have a “gridlock” problem that we can’t seem to resolve because these events may originate from something held outside our conscious memory from early childhood in this life, but those real sticky problems are often rooted in dynamics set up in a prior-life experience. This is an example of how traumas from lifetimes previous to this present one can get stuck in the grooves of our mind without us even knowing it and then those bad experiences actually start to affect other moments in our current lifetime which we might have not even thought about until now but when looked at closely one is able to see how it makes sense because we can see that trauma from the past is slowly reappearing within someone’s life.

Of course, all problems and issues aren’t rooted in experiences from prior lifetimes. It is important to distinguish when we have a current life issue that needs to be addressed through other means, but sometimes the problem can seem similar or even the same as ones from our past. Here are some of the areas in which past life work has traditionally been used include:

Phobias and irrational fears that seem to be unconnected to an experience in the current life
Some chronic physical ailments, sensations and pains in your body will often be there for life.
Dominant attitudes or emotions that seem to persist throughout your life

PLR work is also being applied in a positive way that is quite exciting and rewarding. Rather than targeting traumatic or troubling memories, we can focus on the positive aspects of an individual’s life such as certain skills they acquired or hobbies they enjoy among many other fascinating variations to this innovative technique.

Intake Form

PLR Intake

First Name

Last Name

Address

Email Address

Phone

Age

Relationship

Occupation

Do you suffer from any of the following?

Epileptic Seizures

Advance Bipolar Disorder

Schizophrenia

None of the above

What Present Life issue do you want to focus on with Past Life Regression?

Can you enter into a hypnotic state? Have you practiced self hypnosis? Do you have any questions about what hypnosis is?

Have you experienced hypnosis or hypnotherapy sessions? How many? For what purpose? What was the outcome?

Have you experienced formal Past Life Regression sessions? What was the outcome?

Have you had spontaneous Past Life recall? Describe

Are you a healer? In what modalities?

Have you met or do you know your Spirit Guides? Describe

What are your feelings, thoughts and questions about your issue?

How does the issue affect you? Describe a specific moment in the last few weeks to illustrate, including what you saw, heard and felt.

How long has this been an issue? Has it changed over time?

Who are the Key People involved in your present life issues? Describe your relationship with them in this life, and the current state of relationship.

What information or theory do you already have about the cause and nature of your issue?

What outcomes would you like to get after the sessions?

Do you have any questions before your PLR session? Please enter those questions.

I understand that Sharaz Hossein is not a licensed physician, psychologist, or medical practitioner and the information, techniques, methods, recommendations by Sharaz Hossein are not intended to substitute for diagnosis and care by a qualified physician, nor to encourage the treatment of any illness by persons not recognizably qualified. If you use Rapid Transformational Therapy (RTT) / Past Life Regression Therapy (PLRT) and are under medical care for ANY condition, DO NOT make any adjustments to any prescribed medication without the approval of your doctor. If in any doubt, you should contact your physician.

Acknowledgement

I understand the above statement.

If you are human, leave this field blank.