• Waiver of Liability:  The client voluntarily agrees to be a participant in hypnosis and/or coaching session under the direction of Lindsay Clegg CCHt RN BSN and accepts full responsibility for any and all injury arising from the hypnotherapy and/or coaching sessions. I understand that I will have all choices at all times and can start and end the process at anytime, even during my session. Initials:

     

  • Disclaimer:  I, Lindsay Clegg, am not a trained medical doctor or psychologist.  At no time will I attempt to provide medical or mental health therapy. I do not provide nursing services in this practice.  I advise that you seek a qualified doctor or psychologist if you need help with mental health issues.  Initials:

  • Guarantee and Refund Policy:  No warranty and/or guarantee is given, expressed or implied, for satisfactory results from the hypnotherapy session, as it is impossible to guarantee human behaviors or compliance.  Therefore, no refunds for services are given.  The client understands that change is his/her responsibility.  The hypnotherapist/coach is considered a guide or facilitator in the process. Initials:

     

  • Methods Used: The services I render are held out to the public as non-therapeutic hypnotism, defined as the learning of self-hypnosis to induce positive thinking, create commitment to change and to learn the techniques of self-hypnosis to produce self-control over physical experiences and emotional awareness. I do not represent my services as any form of health care or psychotherapy, and I may make no health benefit claims for my services. Specific techniques may include Body Relaxation/Progressive Muscle Relaxation, Guided Meditation, Regression, Behavior Modification, and Guided/Visual Imagery.  The Client understands that the above modalities are not substitutes for regular medical care, and has been advised to consult with his/her medical doctor of health care practitioner for treatment of any old, new or existing medical conditions. With any medical emergency or if I feel suicidal, I will call 911. Initials:

     

  • Education and Training:  Lindsay Clegg was trained and certified by the Leah Agami, Board Certified Instructor, and Dr. Richard Nonguard of Subliminal Science and is certified as a Certified Clinical Hypnotherapist by the International Certification Board of Clinical Hypnotherapists. She received her Bachelors of Science in Nursing from Samuel Merritt University and Mills College. Initials:

     

  • Fees and Payment Policy:  Payment is due in full at the time of service by cash, PayPal, Venmo, or credit card.  Session fees are subject to review and change.  Twenty four (24) hour cancellation notice required, otherwise client will be billed for the session.  Credit for rescheduling of a missed or unused scheduled pre- paid package session will be honored for up to 30 days from the last scheduled session appointment. Sessions from packages must be used within one year. Initials:

     

  • Minors:  Appointments for children under 18 years of age require written consent from a parent or guardian, who must accompany them at each visit.  Initials:

     

  • West Coast Hypnosis Center reserves the right to refuse service to anyone, at anytime, for any reason. Initials:

     

  • My signature below signifies that I have read the above statement and fully understand and accept the information described above, and agree to participate in a hypnosis and/or coaching session.

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