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What is the reason for seeking our services?
We reserve the right to refuse hypnosis and hypnotherapy services and training to anyone. We do not work with drug addictions, alcoholism, and diagnosed mental illness disorders. I understand that if I am currently working with a medical or mental health care provider and have been diagnosed with a medical or mental health disorder, and I am taking prescription drugs for the disorder, and should I want to work on a behavioral modification issue with hypnotherapy, I am responsible to inform my mental health care provider, and the doctor who may be prescribing any medications, and explain to them what I am considering doing with hypnotherapy for behavioral modification. By writing my initials below I agree to the above statements.
Confidentiality will be strictly maintained except for the following circumstances: (1) with your permission and a signed release of information to a particular person or agency. (2) By law, any report of physical, sexual abuse, or neglect of a minor, or abuse of spouse or an elderly person. (3) If I have reason to assume that you may harm yourself or another person. I use a cell phone so that I am accessible, which cannot be considered 100% secure. By writing my initials below I agree with the above statement.
Cancellation of appointments: On occasion, a situation may arise which prevents you from keeping your scheduled appointment. Please notify me 12 hours in advance of your appointment if you cannot keep it. Except in emergency situations, you will be expected to pay for any sessions that you miss without this advanced notice. If you cannot provide 12 hours advance notice, you have purchased the time as it was reserved for you, and will be billed accordingly. By writing your initials below you agree to the above statement.
Payment for Services: I agree to pay all balances for the sessions scheduled and completed. Payments are to be made before or immediately following each session. Insurance carriers in the State of Utah do not as a practice cover these therapy sessions. I understand I am personally responsible for payments.
I have registered to attend hypnosis, self-hypnosis, and hypnotherapy individual or group sessions of hypnotherapy and trainings with Megan Wiseman. I STATE AND UNDERSTAND THAT I HAVE BEEN DULY ADVISED AND INFORMED THAT HYPNOTHERAPY SESSIONS DONE IN INDIVIDUALY AND/OR GROUP SETTINGS, COULD BE A VERY INTENSE PERSONAL EXPERIENCE, AND I UNDERSTAND AND WARRANT THAT I AM PHYSICALLY, MENTALLY, AND EMOTIONALLTY CAPABLE TO ATTEND THE HYPNOTHERAPY SESSIONS AND/OR SELF-HYPNOSIS TRAINING WORKSHOPS. By writing my full name below I confirm the statement above.
I agree to
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provided by the company. By providing my phone number, I agree to receive text messages from the business.
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