Form
This form is to be completed if you choose to become a client. There is no need to complete this form unless you have already made an appointment with Linda.
PLEASE BE SURE THE COMPLETED FORM GETS TO RON AT LEAST ONE FULL DAY PRIOR TO YOUR APPOINTMENT.
Fax: (908) 301-0056
Mail: 1501 Fox Trail | Mountainside, NJ 07092
Email: Linda@controlexamanxiety.com
In order for me to create the customized Neuro Immersion CD for you, I need to gather some information. In short, I need to know – as specifically as possible – what triggers your exam anxiety and the intensity of anxiety you experience. Why is this important? Remember, the goal of The Neuro Immersion Method is to help de-sensitize your specific anxiety response. This means that I have to know what causes the anxiety response and the extent to which it impacts you. If you need clarification on anything in this survey, please do not hesitate to call the office at 908-301-0039 or email me directly at Ron@ControlExamAnxiety.com anytime.