Please Complete This Form To Book Your Personal Session
Please look for an email from coach(@)leahbutlersmith.com.
How Did You Hear About Enhanced Life Practice?
Personal / Professional Recommendation
Please add a little more detail about how you found us. e.g. the name of the referrer or specific search term.
Have You Ever Had Any Personal Coaching Or Therapy Before? If Yes Please Add Some Detail.
Please Check The Techniques & Programs You Are Most Interested In
Havening (Psychosensory Techniques)
General Life Coaching
Specific Business Coaching
Inner Child Healing
Phobia Treatment (list the specific Phobia below)
Habit Change (Addictions, Alcohol, Weight Issues, Internet etc)
Anxiety & Fear Treatments
Grief & Bereavement
Fertility, Pregnancy, Birth
Limiting Beliefs, Procrastination etc
Confidence, Self Belief, Social Anxiety
Public Speaking Confidence
Physiological Problems eg sweating, pain, stuttering, tinnitus, IBS etc)
Not Listed (please add more detail below)
Please add some detail about the problem (or Goal) you would like to focus on
How will your life look once you've resolved this problem / achieved your goal?