Waiver : Please read carefully
LIABILITY: I hereby release Samia Athar (The Hypnotherapist) from any liability or claims that could be made against her concerning my mental and/or physical well-being during the work that has been outlined and agreed upon now and in the future by filling out this form.
SCOPE OF PRACTICE: I understand that Samia Athar is not a licensed physician, psychologist, or medical practitioner of any kind and that hypnosis should not be considered a replacement for the advice and/or services of a Psychiatrist, Psychologist, Psychotherapist or Doctor.
PARTICIPATION: I give Samia Athar full permission to hypnotize me and to use Rapid Transformational Therapy knowing that by participating fully in the process and be listening to my personalized recording for 21 days, I play an important role in my overall success.
GUARANTEE: I understand that although Rapid Transformational Therapy has an incredibly high success rate, Samia Athar cannot and does not guarantee results since my own personal success depends on many factors that Samia Athar has no control over, including my willingness and desire to affect the changes inside myself.
AUDIO RECORDINGS: I give Samia Athar full permission to make audio recordings that may include my session(s). Samia Athar retains full copyright over any forms of media that may be produced and distributed to me.
PRIVACY: Samia Athar will maintain confidentiality of my session. This session does not replace medical diagnosis or treatment.