Hypnotherapy Disclosure Form by n11FGhGI


									Hypnotherapy Disclosure Form____________________________________________
Waiver of Liability
By their signature below, the above named client voluntarily agrees to be the subject of a
Spiritual Counseling/Hypnosis session and accepts full responsibility for any and all
injury arising from the Spiritual Counseling/Hypnosis session. The client shall hold
harmless all parties involved in the Spiritual Counseling/Hypnosis session including the
Sylvia Browne Hypnosis Training Center, Hypnotist, administrators, founders, directors
and assistants..
The Hypnotist is neither a trained psychologist nor a medical doctor. At no time will the
Hypnotist attempt to provide medical or mental health therapy. The client affirms that the
hypnotherapy is appropriate for them and does not conflict with existing medical or
psychiatric treatment. Always follow the advice of your doctor or other professional
medical practitioner.

No warranty is given, expressed or implied, for satisfactory results from the Spiritual
Counseling/Hypnosis Session.

Tape Recoding
All personal services are tape recorded, at no charge, as a free service to the client. We do
not guarantee that the tape will be audible, fully intact or usable. We will not be
responsible for nor issue refunds for defective or damaged tapes.

Methods Used
The Hypnotist employs Spiritual Counseling and hypnosis techniques to facilitate the
client’s quest for self-improvement. Specific techniques may include: Spiritual
Philosophy, Body Relaxation, Directed Meditation, Age Regression, Cell Memory
Theory, Past-Life Regression, Behavior Modification, Psychic Insight, Psychic Healing,
and/or “Laying On” of Hands.

Training and Education
Spiritual Counseling and Hypnosis training provided by Sylvia Browne Hypnosis
Training Center.

Signature required below if you are mailing this in.


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