Vidal Hypnosis Breakthrough Consultation Application

Takes about 60 seconds to complete.

First Name *

Last Name *

Phone *

Email *

Instagram Handle *

Current yearly income or business revenue *

$0 – $50,000

$50,000 – $100,000

$100,000+

Biggest challenge you want help overcoming right now *

How is this affecting your life, business, income, or relationships? *

If this were permanently solved, what would your life look like in 12 months? *

What would eliminating this problem permanently be worth to you? *

$500 – $3,000

$3,000 – $10,000

$10,000+

If accepted, are you ready to invest in solving this now? *

Yes

Possibly

No