Client Consent Form
Fees: Our service fees are $250.00 for 90 minute sessions. Prepayment must be made at the time of the first session to receive the discount. Personalized mp3's of your session are available for $30.00 and are not discountable. Visa, MasterCard, Venmo, Paypal, cash or check are all acceptable forms of payment. Cash and check are always appreciated.
Cancellation Policy: Your appointment time is reserved exclusively for you. Please arrive promptly to obtain your full session. If you must cancel or reschedule, we require a 48 hour notice. Unless cancelled prior to 48 hours, you are financially responsible for 50% of the scheduled fee. If you must cancel or reschedule due to an emergency, please notify us as soon as possible.
Confidentiality: All sessions are confidential. We will not release any information to anyone without written authorization from you, except as provided by law.
Notice: Hypnosis is a natural and safe, self-help process. Hypnotherapy is not the practice of medicine or psychotherapy. The hypnotherapy services provided are for educational and self-improvement purposes and are not intended for the diagnosis or treatment of any medical or psychological condition. If you have an ongoing medical illness, mental disability or mental illness, please consult a medical doctor, psychiatrist or psychologist licensed by the State of California. We do not represent our services as any form of health care and despite research to the contrary, by law we may make no health benefit claims for our services.
Redress: We offer hypnosis services in accordance with the Code of Ethics and Standards prescribed by the American Board of Hypnotherapy. It is your right to refuse any aspect of our services and to seek the services of another hypnotherapist at any time.
Client Consent and Release: I am of legal age and in consideration of my acceptance as a participant in hypnosis and hypnotherapy sessions, coaching, hypno-healing, massage therapy or any other services provided by San Clemente Vitality Center, Soul Thriving and Victoria Tabb C.ht, for myself, my heirs, executors, administrators and assignees, do hereby release and discharge San Clemente Vitality Center, Soul Thriving and Victoria Tabb and any of their employees or other participants from all claims of damages, copyright, demands or actions whatsoever in any manner arising from my participation. Further, I understand that audio recordings are made during some sessions, and that Victoria Tabb, retains the copyright of these recordings.
I declare that I have read this consent and release and that I fully understand and agree to the terms described. I acknowledge receipt of a copy of this statement.
(If under 18, must be signed by legal guardian)