Hypnotherapy Informed Consent Form

Welcome to Hypnotherapy

Before proceeding with the treatment of hypnotherapy, it is important that you, as the "Client" understands the necessary information about the treatment.

This form contains the important information about hypnotherapy including our policies. This explains the rights of our patients or clients, the privacy protection, and how we use your personal information.

Signing this document represents our understanding with regard to the agreement. Thus, it is important that aside from reading over the contents of the form, it is likewise discuss any questions you might have. Hypnotherapy requires establishing a relationship between the client/patient and the therapist..

Just like the rights that persons can have, these rights are limited.  There are also legal limitations to those rights that you should be aware of. 

Nature of Hypnotherapy

Hypnotherapy is a complementary healing modality aimed at addressing subconscious beliefs, emotional blocks, habits, and stress-related responses. It is not a substitute for medical or psychological treatment by licensed professionals.

Hypnotherapy is not psychotherapy and does not diagnose or treat mental health disorders. The hypnotherapist and client work collaboratively, with the client actively participating in the process by applying the tools and techniques learned during sessions.

Confidentiality and Communication

All personal information, discussions, and session content are confidential. Information will only be shared with your written consent or if required by law due to safety concerns.

I use secure online platforms for video sessions and may communicate via email or text for scheduling. While I take precautions to protect your data, the privacy of digital communications cannot be fully guaranteed.

Session Structure

• Sessions typically last 60 to 90 minutes.

• Some sessions may include age regression, inner child healing, or other subconscious work.

• The beginning and end of the session (induction and healing) may be recorded for your personal use.

You may request a copy of your session recording via email. Please note: sending files via email carries a small risk to confidentiality.

 

Risks and Expectations

• Hypnotherapy may bring up strong or uncomfortable emotions as you explore past experiences and patterns.

• Some clients experience quick results, while others may need more time.

• Hypnotherapy is not guaranteed to work for everyone, and your commitment to the process plays a key role in its success.

Benefits

There are many benefits to hypnotherapy. The hypnotic state allows the patient to be more receptive to discussion and suggestions. Thus, it helps treating phobias, anger, fears, depression, stress, loss and grief, and anxiety among others. It can also be used as a treatment of controling and overcoming habits. To achieve the ideal results, the full and active cooperation of the patient is required. 

Fees and Cancellation Policy

• Session Fee: $110

• Duration: 60–90 minutes

• Payment methods accepted: cash, e-transfer, PayPal

• Cancellations must be made at least 24 hours in advance.

• Late cancellations may incur a $50 fee.

• No-shows will be charged in full.

By signing this form, you acknowledge that:

•You have read and understood the information provided above.

•You have had the opportunity to ask questions regarding the therapy and its process, and all your questions have been answered to your satisfaction.

•You understand that hypnotherapy is a complementary service and does not replace medical or licensed psychological care.

•You declare that you are of legal age and of sound mind to give full and informed consent.

•Your signature below is your express agreement to voluntarily participate in hypnotherapy sessions, understanding both the potential risks and benefits involved.