Client consent form

CONSENT FORM

Client Agreement – Code of Care

• The client will be treated with respect at all times.
• Disclosure of all information during the Initial Consultation and subsequent sessions will remain confidential.
• The hypnotherapist has a professional obligation to report to relevant authorities any concerns they believe where the client may intend to harm themselves, the therapist or others.
• If the client is receiving medical treatment then a diagnosis must be sought when possible, and health professionals may be informed of hypnotherapy treatment.
• A copy of the Association for Professional Hypnosis and Psychotherapy (APHP) Code of ethics is readily available.

Consent for Treatment

• The therapist has fully explained the procedures and treatment.
• I understand that listening to the track every night is an important and essential aspect to the treatment.
• I understand the success of the treatment, in part, is determined by the desire to achieve the changes and the commitment to the format of the sessions.
• A respectful relationship will be maintained between the client and the therapist.

Cancellation Policy

• I operate a busy practice with a waiting list. Please be considerate when cancelling an appointment, and where possible give at least 48 hours notice.
• The appointment fee will be charged in full, if there is less than 24 hours cancellation notice given.