Hypnotherapy Treatment Waiver Form

I, the undersigned, hereby voluntarily consent to participate in hypnotherapy sessions provided by the aforementioned hypnotherapist. I acknowledge that I have been fully informed about the nature and scope of the hypnotherapy sessions and that I am participating in these sessions of my own free will.

1. Nature of Hypnotherapy: Hypnotherapy involves the use of relaxation and focused attention techniques to alter thought patterns, behaviours, and emotions. It is not a substitute for medical, psychological, or psychiatric treatment, and I understand that the hypnotherapist does not diagnose, treat, or prescribe for medical or psychological conditions.
2. Possible Risks: While hypnotherapy is generally considered safe, there are potential risks, including but not limited to temporary dizziness, anxiety, or emotional discomfort. The hypnotherapist has explained these potential risks, and I understand them.
3. Confidentiality: I understand that all information shared during sessions will remain confidential, except where required by law (e.g., in cases of child abuse or threats of harm to oneself or others). I have been informed of the privacy policy and understand its terms.
4. Personal Responsibility: I understand that my active participation and willingness to engage in hypnotherapy are essential for its effectiveness. I am responsible for my actions and any decisions made during or after the hypnotherapy sessions.
5. Right to Withdraw: I understand that I have the right to discontinue hypnotherapy at any time. Should I feel uncomfortable or unwilling to proceed, I may end my participation without consequence.
6. No Guarantee of Results: I understand that hypnotherapy does not guarantee specific outcomes or results, as it may vary depending on the individual and their commitment to the process.
7. Medical Conditions: I have disclosed any known medical or psychological conditions to the hypnotherapist. I agree to inform the hypnotherapist of any changes in my health or well-being.

Consent to Treatment

By signing below, I acknowledge that I have read, understood, and voluntarily agree to the terms and conditions outlined in this waiver form. I consent to receiving hypnotherapy sessions under these conditions and hold the hypnotherapist harmless for any effects arising from my participation.