BIRKDALE HYPNOTHERAPY

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 Solution Focused Hypnotherapy Code of practice is readily available.
  • This complies with that of the CNCH, a Department of Health supported Register of which Catherine Eland is a member.

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.

I have read the above agreement and accept the treatment on those terms:

I am happy for you to contact my GP.

I have confirmed that I have read the GDPR Terms and Conditions and I am aware of how my data will be processed and stored:

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