** Hypnosis Therapy Consent and Liability Waiver Form **
This form is designed to inform you about the potential risks and benefits associated with hypnosis therapy during and after the procedure and to state that you accept these risks. Signing this form means you agree not to hold the hypnosis therapy center liable for any adverse events that may occur during or after the therapy. Please read the following information carefully and sign the form to confirm that you understand and accept it.
** Consent and Acknowledgement **
Please read the following information carefully and check the boxes to indicate that you understand and accept each statement.
1. ** Understanding Hypnosis Therapy **
2. ** Voluntary Participation **
3. ** Expected Benefits **
4. ** Possible Risks and Discomforts **
5. ** Confidentiality **
6. ** Right to Withdraw **
7. ** Touch and Consent **
** Health Declaration **
Please check the boxes to indicate that you do not have any of the following conditions::
** Hypnosis Therapy Pre and Post Instructions **
Hypnosis Therapy I agree to follow the instructions below before and after the treatment.:
** Hypnosis Therapy Before: **
** Hypnosis Therapy After: **
** Additional Precautions and Information **
** Consent and Acknowledgement **
By signing below, I confirm that I have been informed about the risks and benefits mentioned above and that I accept these risks. I also declare that I am signing this form of my own free will. I accept that I will not hold the hypnosis therapy center liable for any adverse events that may occur during or after hypnosis therapy.
