PLEASE READ THROUGH THE FOLLOWING INFORMATION

Thank you for completing your payment for your Private Session with Robert Gene Smith. Please follow the steps below to ensure that you and Robert are both well prepared for this life-changing session. All of this information must be submitted at least 48 hours ahead of your session in order to move forward. If you have any questions please send them sessions@skillstochange.com

 

Step 1 – Please fill out the Private Session Agreement below. Once you hit submit, you are done.

 

Step 2 – Read the information provided, watch the video about how to create your Peace List, and then fill out the Peace List provided below. When you have completed your Peace List, please hit submit and then you are finished. If you have any questions about the Peace List or how it works, please reach out to sessions@skillstochange.com

 

Step 3 – Watch the video about making a Happy Journal, and then get started on yours! Have fun!

 

Step 4 – Once you have completed steps 1 – 3, please visit the link at the bottom of the page and set your date/time for your session. If you have already done this – you’re ready!

PRIVATE SESSION AGREEMENT

Private Session Agreement with Robert G. Smith

Robert's private session agreement for people doing one-to-one sessions with him.
  • ABOUT ROBERT: Robert G. Smith is a Personal Success Coach, NLP Practitioner, and Stress Relief, Specialist. His mission is to bring personal performance tools to the attention of others. His quest is a spiritual one and, accordingly, is an ordained minister. Robert’s message is this: “You can live a stress-free life and be successful in everything you do.” His goal is to give you the tools to live a happy and successful life. Robert has studied many forms of alternative healing and has gained knowledge about how the mind and body works. He has trained with some of America’s greatest transformational teachers such as Dr. Richard Bandler, co-developer of Neuro-Linguistic Programming (NLP), Gary Craig, developer of Emotional Freedom Technique (EFT) and Dr. Larry Nims, developer of Be Set Free Fast (BSFF). He has taken these powerful systems that work, combining, simplifying and amplifying them to create FasterEFT. His technique has been highly successful and used by many. Robert is not a psychologist, dietician, medical doctor, or a therapist and has no licensing or formal training in these fields. Disclosure, Responsibility Statement & Client Agreement (The “client” is the signer below)


    •  


     

    1. I (the client) understand that Robert G. Smith is not a licensed counselor, psychologist, therapist, medical doctor, nutritionist or any other medical professional, he has no formal training in these fields and he does not portray himself as such.


    2. I (the client) accept complete responsibility for my emotional and/or physical wellbeing before, during and after sessions or classes, and I will instruct others I share these techniques with to take the same responsibility for them.


    3. I (the client) agree that it is my responsibility to notify my therapist and/or physician prior to using these skills and agree to their supervision if suggested. I will continue to take all my medications as prescribed and remain under the care of my physician or therapist for any medical, emotional or mental condition for which I am currently being treated or believe I may need treatment.


    4. I (the client) will not use these techniques to try to solve a problem where my common sense would tell me it is not appropriate.


    5. I (the client) take full responsibility for what I do with these techniques and will hold harmless Robert G. Smith, or anyone else associated with the techniques, from any claims made by myself, or anyone whom I seek to help. Subject to the other provisions of this agreement, I may use any of the techniques on behalf of others or myself.


    6. I (the client) understand that the services provided by Robert G. Smith are limited to education pertaining to my overall wellbeing. I understand these services may include his physically tapping on my body at various acupressure meridian points. I grant my permission for limited physical contact. I agree to tell him immediately if it causes me any physical discomfort. I understand that these techniques may reveal some problems I had forgotten, but they don’t cause new problems. I understand I can accept or not accept any recommendations and I can terminate our relationship at any time.


    7. I (the client) understand that my full identity will NOT be disclosed without my prior consent, if the issues I address during PRIVATE SESSIONS are shared with others in a general way, for the purpose of educating them about these techniques.


    8. In the event I (the client) am in a group session or class, which is being recorded on video and/or audio media, I agree for Robert G. Smith to use my name, image, likeness and/or voice. I hereby release all claims on confidentiality, interest, royalties, reproductions, distributions and public access of such media.


    9. In the event a private session is recorded in the format of a written document, video or audio media, I (the client) understand that all records are confidential and will be for private use by Robert G. Smith or made available to me for an additional fee. Any records of private sessions will not be viewed by anyone else without my prior written consent. I (the client) will not record the session without Robert his knowledge and permission.


    10. I (the client) understand that I can reschedule my sessions through session@fastereft.com if done so 48 hours or more prior to the session and that I will not receive a refund if I reschedule less than these 48 hours or if I don’t show up at the time of the session. I (the client) also understand that a session takes two hours and that these two hours begin at the scheduled time of appointment.


    11. I (the client) have not tweaked or altered the original Private Session Agreement before signing.


    12. I (the client) acknowledge that I have read the above agreement, understand it completely, and have received a copy of the same. I, therefore, retain Robert G. Smith, as the Creator of FasterEFT and voluntarily make and grant this Waiver and Assumption of Risk in favor of Robert G. Smith, Skills to Change Institute Inc, as consideration for monies paid to the Provider.



      

    Sign below indicating that you have read and understood the above information.

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

THE PEACE LIST

The Peace List

Step 1 of 2

  • INSTRUCTIONS FOR YOUR FIRST SESSION




    All private sessions are either conducted in person, over the phone or via Skype or Zoom and are strictly confidential.

    Please follow the instructions carefully. It allows Robert to use as much time possible to actually tap with you.

    1. Watch the video below to understand the Peace List Process.
    2. Make your Peace List
      • Make bullet points with events, things you witnessed, experienced, including sexual, physical, and emotional abuses or inappropriate behaviors and include a one-liner of a specific memory with each bullet point. (random examples on page 2)
      • It doesn’t need to be in chronological order, or it could be. You can start at birth and move forward.
      • Mention any surgeries or illnesses you experienced during your life.
      • It could further include accidents, moves (of yourself or someone close to you), hurts, fears, people you hate or cannot stand to be around.
      • It could be dreams, movies, past life experiences, or stories told.
      • Write it down even if you think you cleared it, doesn’t bother you or already tapped on it.
      • If you have physical pain, write down when it happened, the places, events, stories, what it feels like, the emotions about it, who else has it, and how it affects you today.

    You do not need to tell the whole story as I don’t want you to re-live the story while you make the list. When you write this list, it might still stir up emotions and hurts but remember: it is not happening while you write it. Realize it is within you, and you want it cleared and healed. Don’t go into the story and tap as you go along.
    Please type your Peace List using the Peace List form and return it solely as a Word .doc.

    All lists are kept confidential.

    1. Please include:
      • Your main goal for the session
      • Expected outcome
      • 2 happy memories: moments when you felt very happy, on top of the world
      • Medication (no dose) including what you are using the medication for and when you started to use it
    • Send in forms
    • Forward this information, along with your signed Private Session Agreement form, to sessions@skillstochange.com 
    • Please send both your Peace List and your signed agreement before or on the day indicated in your email, or within a week of receiving the documents. 
    • We need to reschedule your session in case we don’t receive the documents in time. 
    • Be sure to include your Skype ID 
    • Start your session 
    • You will initiate Skype contact with Robert under his Skype name FasterEFT on the day and hour of your appointment. 
    • Set up your computer in time. Robert has a busy schedule. You have scheduled for 2 hours. If you are late, the session will be shorter. 
    • If a session is performed over Zoom, we will send you a link in time for the session. 
    • If your session takes place over the phone, please notify us on beforehand so we can make the correct arrangements. 
    • If your session is in person, we will let you know where you and Robert will meet for the session. 
    • It is not allowed to record the session. 

     

    Cancellations
    Please give 48 hours’ notice if you need to reschedule your appointment. It might take 3 or more weeks before we can reschedule. We cannot refund cancelled private sessions. 

     

    EXAMPLES OF PEACE LIST TOPICS




    These random examples of bullet points and specific memories might help you to create your Peace List. Please use your Peace List form for your Peace List and sent it as a Word document. 

    • My mom told me that my dad wasn’t present at my birth, because ..... 
    • At age ... my mother told me that they found me in my baby bed at age 6 months with very frightened eyes. 
    • I have always felt anxious. 
      • The first time I remember was... (always example, online 1/2 lines)  
      • I recall being ... years old and ......  
      • Mom told me that at my first day of school, I ....  
      • I would also be afraid in the dark. Once I .....  
      • I procrastinate when I have to ..... 
      • I remember when ....
      • Whenever I start a new job, I ..... 
    • I have fear of flying.
      • I have never felt comfortable in a plane. 
      • I remember seeing a movie/on the news where ... 
      • (or) being on a flight at age .. and ...
      • (or) hearing my uncle, dad's brother, also has a fear of flying o 
      • Days before I have to fly I feel..... 
      • Once I'm on the plane I ...... 
    • I was raped when I was .... y/o o 
      • I was at a party with friends. I remember .... He/She ..... 
      • He/She left me ....  
      • When I told my mother she .... 
      • When I told my doctor they….
    • I have fear of failure 
      • I remember when I was at school ....  
      • I remember my mother always gets annoyed when I needed help with my homework. She would lecture me while I had to stand there and listen. She would slowly loose her temper while lecturing. 
    • My dad had an alcohol problem which started when I was ... y/o  
      • In the weekends, we always had to be quiet  
      • I remember he would miss my baseball games, even though he said he would be there.  
      • I would lay in bed and here my parents ....... 
    • My girlfriend ... broke up with me when I was ... y/o  
      • I came home one day and .....
    • I ended my marriage with .... when I was ... y/o 
      • I always felt…
      • I remember once when… 
      • No matter what I said he/she would respond with… 
    • My parents told me a lot of stories about the war 
      • They told me how… 
      • They struck fear in me because… 
    • I've had my tonsils removed when I was ... y/o
      • I felt…. At the hospital. After I went home my mom/dad gave me ice cream 
    • I was circumcised at age .... 
      • I felt very special but at the same time .... I remember .... 
    • When I was ... y/o, we moved home. 
      • I had to leave my best friend behind. I remember .... 
    • At the new school, It was hard to make new friends. Everybody knew each other. 
      • One day… 

     

     

     

     

THE HAPPY JOURNAL

SET YOUR DATE/TIME

Email Sessions@skillstochange.com to set up/confirm your appointment time and date.