General Registration - Hypnosis by Doctors :Hypnosis by Doctors

General Registration

You will be contacted for an appointment when we receive your completed form.

Chronic Pain • Weight Loss • Stop Smoking • Excessive Drinking • Drug Abuse • Break Ups
Phobias • Gambling • Depression • Stress • Memory Improvement

Please review the testimonials after submitting your form.

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- I would rather have a phone consultation
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Once you make this payment complete the second half of the form that asks details about your lifestyle problem. All information is confidential and only seen by Dr. Smith.
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Please call or text when you complete this form to schedule a free consultation 334-233-5610
Please Return to the Registration Page and See Testimonials Before Your Appointment.

WEIGHT LOSS

PAIN & MIGRAINE

STOP SMOKING

ANXIETY & DEPRESSION

ALCOHOL & DRUGS

GAMBLING

Dr. Clinton W. Smith, Psy.D

Clinical Psychologist & Hypnotherapist

For Assistance:

Call Us: (334)233-5610
Email Us: DrClintonwSmith@gmail.com
Office Address: 495 St. Luke Drive Montgomery, AL 36117

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