Client Instructions:
Write down the items you are hoping to see shifts in as you continue
with your NeurOptimal
®
Sessions. How will you know this is helping
you? Please write down measurable statements (ie. “Homework is done
in under an hour” vs. “Homework is easy”).
Trainer Instructions:
When they hand you back the sheets, have a look at the statements.
Are they indeed measurable? If they are not, ask questions to get you
measurable information. Ie. What does “Homework is easy” mean to you?
It can also be interesting to ask questions about a Client’s everyday life, to
pull more statements out of them. Ie. if the Client has children, ask them
how the dinner/homework/bath time/bedtime routine is in their house.
Do they have a hard time keeping it together? If yes, what happens?
How often in the week does this happen? What would need to be
different in this routine for them to feel NeurOptimal® has had an effect
on that part of their life? This can pertain to anything-- morning or
evening routines, work life, social life, family life etc.
Because NeurOptimal
®
only provides information, not direction, to
your brain, it is incredibly safe. However, the process of change can be
unfamiliar to many and some may find it disorienting. For this reason,
we feel every person who runs on NeurOptimal
®
should be provided
full information on what they might expect ahead of time. Please have
every person you run read and sign the Consent form. This provides
them with important information and you with written confirmation
of their willingness to be run. We like to keep our documents for ten
years (mainly because tax forms are kept for seven and then we add
some leeway), but if you have legal counsel that suggests differently,
that’s fine. Current copies of the consent form are always available
through PASS>Forms section.
MY WISHLIST
CONSENT FORM
1.
2.
3.
I would be pleased if the following shifts were to take place in my life:
TRACKING YOUR SHIFTS:
MY WISHLIST
NAME:
DATE:
PRE/ONGOING/POST
SESSION#:
Note:
Please note that NeurOptimal® does not diagnose, treat, mitigate, prevent or cure any disease, disorder or abnormal physical state, nor does it restore, modify
or correct the body’s structure or functioning. Information provided is for reference and tracking purposes only.
www.neuroptimal.com
Tracking Progress Tools
D
Tracking Progress
5
25
