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Brain Health session Preparation

HOPE Wellness Institute

9801 Fair Oaks Blvd. Suite 200

Fair Oaks, CA 95628

Call (916) 965-6558

Achieving My Brain Health Goal

My Goal in doing Brain Health Sessions is:

When my goal fully realized, describe the details of how I experience life better.

My Objective is; (can be more than 1)

Recovery

Stabilize

Improvement

Optimize

I understand my brain works better by growing new neural pathways.

I need more information

Yes

I understand that each new neural pathway takes a few days to form and about 60 to 90 days active support to mature or become strong enough to continue without conscious support..

I need more information

Yes

I understand that if I use thought patterns, behaviors, chemicals (like alcohol) and even treatments that support or trigger old patterns they will slow and may override maturing neural pathways.

I need more information

Yes

Questions and/or additional thoughts:

Name:

Email:

Phone:

Thank you for contacting us.
We will get back to you as soon as possible.

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* How long it takes to form a habit.

Link for Test for ACE Mental Health Score

Goal & Health management

Click below for a form to provide information related to your goal. We need information on how you are managing this and your overall health in these areas:

Thoughts
Behaviors
Chemistry (medications, supplements, nutritionals . . .)
Treatments

Good projections of your time, energy and financial investment and good results are based on good information. We need at least 6 months accurate history and where the issues is older, I need a history back to the start.

Education

Priorities - Subconscious vs Conscious

Markers

Choosing Thought and Behavioral Support items

Peaks & Valleys/ Swinging

Quantum Steps

Education

Understanding my Brain's Journey

Click to use Video

Forms

Understanding my Brain's Journey

Click for Hold Harmless form

Click Medications, supplements form

Please Complete the form below.

All are optional so fill out what applies. We will address these in your next coaching session so the more you give us,

the more we can help.

I don't know who it is without your name at the bottom.

Before my Fair Oaks Cereset Sessions

I feel like these areas of my life are "stuck"

I most want my Cereset Sessions to help me change this:

This is how I experience life now:

This is how I will experience life when I reach my goal.

My Biggest recent Success has been

My Biggest Current Challenge has been

My energy level is

My mood quality & stability is

My Sleep is

My ability to manage stress is

My thinking - memory, thought process, attention, focus, recall, conceptulizing . . . is

Additional Details or Comments:

Name:

Email:

Phone:

Thank you for submitting your Fair Oaks Cereset Follow up. It helps us to track your progress.

We are always available at 916-534-7577 when you have a need or questions.

Bill

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We appreciate your following up and

If this persists, please call 916-534-7577

Bill

This is a page to help you document. If doing this with audio on is not available or appropriate, scroll down and there is a text entry tool also. Thanks.

Permission to reprint our content will most likely be granted

I will be adding links for additional educational information soon.

Thought and behavior change ideas Improve Energy Improve Mood Improve Sleep Improve Stress Management Improve Thinking

Contact Us

Daily Energy

I have low energy all day long

I wake with energy but run out before I run out of day

I run on "nervous" energy

I rely on caffeine or energy drinks to get me through the day

I have too much enregy - always doing something never relaxing.

I often rely on alcohol or similar to help me slow down and unwind.

Mood

I struggle with anger, frustration and gend to blame otherss.

I struggle with sadness and guilt and tend to blame myself.

I struggle with strong emotional responses tht swing from anger to sadness very quickly.

I struggle with low emotional responses and sometimes feel very disconnected from my emotions.

I often make decisions based on my emotions rather than logic.

I tend to react strongly to my emotions ain the moment and often regret my reactions later.

I feel I have little or no control over my emotions and emotional responses.

I tend to view life from a negat

I often wish my mood was more stable.

Additional Thoughts:

Name:

Email:

Phone:

Thank you for contacting us.
We will get back to you as soon as possible.

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Fair Oaks Cereset

Call (916) 534-7577 Cereset Website Client Experiences Research Papers