Consent Form – Solution Focused Hypnotherapy
Before beginning therapy with Kim Sweetland of Kim Sweetland Hypnotherapy, this consent form must be completed and returned.
Client Information
For adults (18+): You must complete and sign this form yourself.
For minors (under 18): A parent or legal guardian must complete and sign this form on their behalf.
Client Commitment
By signing this form, I confirm that:
1. I understand the nature of Solution Focused Hypnotherapy and Psychotherapy and have had the process explained to me.
2. I commit to engaging in a respectful and professional relationship with my therapist.
3. I will not attend any session under the influence of alcohol or drugs. If my therapist believes I am under the influence, the session will not proceed, and I may be charged the full session fee.
4. I understand that results vary and that while therapy has been beneficial for many, there are no guarantees of specific outcomes.
5. I acknowledge my responsibility in therapy, including participating in positive activities between sessions to maximise my progress.
6. I understand it is my responsibility to enquire if I am unsure or do not understand anything relating to my course of therapy.
7. I understand that the therapist's estimated duration of therapy is approximate, and I am responsible for deciding when to space out or end my sessions.
Session Attendance & Cancellations
1. Sessions should be attended regularly and on time.
2. If I am unable to attend, I will provide a minimum of 24 hours’ notice via email or text message. Failure to do so may result in the full session fee being charged.
3. If I arrive late, the session will still finish at the scheduled time. If I arrive more than 10 minutes late, the session cannot proceed, and a full charge may apply.
4. If the therapist must cancel a session, any pre-paid fees will be refunded or credited to a future session.
For Clients Under 18
1. I confirm that I am the parent/legal guardian of the client and give consent for them to receive therapy.
2. I consent to the therapist working alone with my child where appropriate and understand I may request to see a DBS (Disclosure and Barring Service) certificate at any time.
3. I understand I may be asked to accompany my child at their sessions.
4. I will support and encourage my child to engage fully in therapy and complete any recommended activities between sessions.
Confidentiality & Data Protection
Therapy sessions are confidential, except where the therapist deems it necessary to break confidentiality for safeguarding reasons or to prevent a crime.
Therapy notes will be securely stored for:
1. Adults: 8 years from the completion of therapy.
2. Minors: Until the client reaches the age of 25.
3. Clients (or parents of minors) may request access to, amendment of, or deletion of notes in writing.
4. In the event of an emergency where Kim Sweetland is unable to contact me regarding an appointment change, I understand that Christopher Sweetland may access my contact details for this sole purpose and is bound by confidentiality laws.
Additional Considerations
1. There is no parking directly outside the clinic due to resident parking restrictions. Clients must park legally in nearby non-restricted areas or public car parks. Kim Sweetland Hypnotherapy is not responsible for any fines incurred.
2. It is not advisable to undertake multiple therapies simultaneously, as conflicting information may hinder progress. If I (or my child) am under the care of a medical or support team, I will consult them before starting or continuing therapy.
Agreement
I confirm that I have read and accept the Terms & Conditions:
https://www.kimhypnotherapy.co.uk/terms-and-conditions
I confirm that I have read and accept the Privacy Policy:
https://www.kimhypnotherapy.co.uk/policies