TERMS & CONDITIONS: I understand and agree that hypnotherapy requires me to make a commitment to myself to attend treatment regularly. I understand that sessions should be no more than 1 week apart for stress and anxiety management (generally 2 weeks for weight loss). I understand that payment is required up front or as agreed for terms, which includes a $50 additional fee.
HYPNOTHERAPY SERVICES: The provision of Hypnotherapy services entails the collection and recording of personal information relevant to your current situation. This information is a necessary part of your assessment and treatment protocol.
ACCESS: Any information gathered, recorded, and filed is available upon request.
CONFIDENTIALITY: All personal information gathered during the course of Hypnotherapy shall remain confidential and secure except if:
1. It is subpoenaed by a court, or
2. Prior approval has been obtained to:
a. Provide a written report to another professional or agency. e.g. a GP or a solicitor, or
b. Discuss the material with another person. e.g. a parent or employer.
3. REFERRAL: Permission is hereby given for my details to be cross referenced, and/or discussed, with another Health Care Provider, Parent or Other person if deemed necessary.
4. Statistical data, separated from all personal identification may potentially be collected and shared with other members of a research group
5. Sessions may be recorded and remain confidential