Please take some time to write out in detail what your IDEAL OUTCOME is for your session. By getting clear on what you DO want, I can guide you in that direction.

• Nicole White Wellness - Hypnotherapy & Coaching Waiver

  A. Session Fees

  Client agrees to pay Nicole White Wellness at the time of booking to secure their appointment date and time. This is a non-refundable retainer fee that goes toward your session. The balance is due at the time of the session. The session fee covers the time, audio recording and followup of the session.

  B. Rescheduling

  If an illness or situation prevents the session from taking place, the client may reschedule their session at least 24 hours prior to their session without penalty. Should client fail to give 24 hours notice, or decide to completely cancel the session, this session fee is forfeited and will not be refunded. Nicole White reserves the right to reschedule due to illness, internet interruptions, equipment malfunction, or other circumstances beyond her control.

  C. Payment

  All payments are due in full unless payment arrangements have been made. The session will not be scheduled until payment in full is received. If client has arranged a payment plan, order will be placed after the final payment has been received.

   

  D. Liability

   Client hereby releases Nicole White (The hypnotist & coach) 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. 

   

  E. Scope of Practice

  I understand that ​Nicole White 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. 

   

  F. Participation 

  I give ​Nicole White full permission to hypnotize me and to use Rapid Transformational Therapy & Coaching knowing that by participating fully in the process and by listening to my personalized recording for 21 days I play an important role in my overall success. 

   

  G. Guarantee

  I understand that although Rapid Transformational Therapy has an incredibly high success rate, ​Nicole White ​cannot and does not guarantee results since my own personal success depends on many factors that ​Nicole White has no ​control over, including my willingness and desire to affect the changes inside of myself. 

   

  H. Audio Recording(s)

  I give ​Nicole White full permission to make audio recordings that may include my voice. I understand that if a recording (or recordings) are made during or after my session(s) ​Nicole White ​retains full copyright over any forms of media that may be produced and distributed to me. 

   

  I. Deepening Process (In Person Clients)

  I hereby grant permission to ​Nicole White to respectfully lift my arm, touch my shoulder, or rock my head during my Rapid Transformational session(s) in order to help facilitate the deepening process. 

   

  J. Confidentiality

  By signing this form, I consent that ​Nicole White may release information to a specific individual or agency if it has been determined that a child or elder is at risk of or is currently being abused; if I, as a client, am in imminent danger to myself or others; or if a subpoena of records has been requested. 

  I also understand that, at any time, Nicole White ​may discuss aspects of my case with other colleagues keeping my full name. Identity completely confidential always unless I have given permission otherwise.

   

   K. Session Agreement

  Client agrees to arrive at his/her session completely sober. This means that if you are on prescription pain killers, CBD, etc.., that you will schedule your session at a time where you do not have these substances in your system. An important part of the process is to be fully awake and aware. If you have any questions or concerns, reach out to Nicole White via email before your session.