top of page

Client and Therapist Agreement

 

I accept and understand the therapy I receive is for the purpose of: (tick appropriate)
 

  • Relaxation

  • Confidence Building

  • Overcoming equestrian issues

  • Weight Management

  • Helping emotional issues

  • Changing unwanted behaviours or habits.

  • To relieve the symptoms of Phobia/Anxiety

  • Stress management

 

And should not be construed as a substitute for medical examination, diagnosis or treatment.

 

 

I agree:

 

  • The therapist cannot guarantee the success of therapy or cure any illness or condition.

  • I will carry out tasks if requested (reading, using anchors, breathing techniques etc.) between sessions to give me the best chance of success.

  • It is my responsibility to inform the therapist of any changes in my health throughout the duration of therapy.

 

I have been informed of:

 

  • The qualifications of my therapist (Diploma – Clinical Hypnotherapist, Diploma EMDR)

  • How to contact my therapist (07920 497912 OR louisehamiltonhypnotherapy@outlook.com OR Facebook PM)

  • Fee structure (£95 per session, 1st session payable on booking. 2nd session payable on day of 1st session& so forth)

  • Cancellation Policy –  I operate a strict 3 working day cancellation policy. In the event of needing to reschedule

       an appointment, kindly provide me with a minimum of 3 working days notice. In the event of a no show without

       good reason or late cancellation, I reserve the right to charge you a fee of £95 which covers a 1 hour session. Missed appointments cost time and money, extending waiting lists and prevents me from seeing other clients. I ask for your understanding and cooperation in this matter.

  • Professional Memberships (General Hypnotherapy Register, National Hypnotherapy Society)

  • Confidentiality will be maintained in all but the most exceptional circumstances.  These can only include (criminal or civil court cases where a court order is made demanding disclosure – includes coroners courts and fatal accident enquiries in Scotland) and where there is good cause to believe that not to disclose would cause danger of serious harm to others.  Most standards of confidentiality applied in professional contexts are based on the common law concept of “The Greater Good”.  The sharing of anonymous case histories with supervisors, peer-support groups or for training purposes is not a breach of professional confidentiality.  The sharing of open case histories with supervisors and any referring NHS medical practitioner is also not a breach.

 

  • I hereby give my permission to the therapist to use hypnosis or other therapy deemed as appropriate.

 

 

         By ticking this box I give my full consent and opt in to being contacted by Louise Hamilton Hypnotherapy by email, text and/or telephone.

 

 

                  Signed (Client)    

 

        Print (Client)                                                                                                      Date

 

 

        Signed (Therapist)                                                                                            Date

bottom of page