Integration of Clinical Hypnosis with Patients in Cancer Care Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Prior Hypnosis Training * License Field, State & License Number * Agency/ Organization Name as you would like it to appear on your certificate * Fee of $295 Payable via Zelle to Wellness Consultants International 919 403-7229 Or Venmo Business Acounts : @MedicalHypnosisConsultants Thank you!