Organization Type:
Private Company/Organization
Publicly Traded Company
Law Enforcement Agency
Non-Law Enforcement Government Entity
Has the person to be hypnotized ever been hypnotized before? Yes No
If Yes, provide brief synopsis:
Is the person to be hypnotized currently under a doctor's care? Yes No
*If Yes, you'll be asked to provide details when you are contacted.
Is the need for the forensic hypnosis session due to a crime being committed? Yes No
If Yes, state the crime:
State and/or country where the crime occurred:
*You will be asked to provide details of law enforcement involvement and the case investigator's
contact information when contacted.
CONTACT INFORMATION
What is the preferred method of contacting you? Email Telephone
What is the best time for Mark Riordan to contact you?
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