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Adult waiver form

Last updated on 04/11/2022

 

I, hereby release Catherine Jenkins (The hypnotherapist) from any liability or claims that could be made against her concerning my mental and/or physical well-being during the work that has been outlined and agreed upon (now and in the future) by agreeing to these conditions. I also understand that Rapid Transformational Therapy and Hypnosis is not recommended for anyone suffering from psychosis, have an history of psychosis, schizophrenia, or epilepsy and If I have suffered from any of those conditions or still suffer from it now, it will be made very clear to Catherine Jenkins. 


Scope of Practice

 

I understand that Catherine Jenkins is not a licensed physician, psychologist, or medical practitioner of any kind and that hypnosis should not be considered a replacement for the advice and/ or services, of a psychiatrist, psychologist, psychotherapist, or doctor.
 

Participation
 

I give Catherine Jenkins full permission to hypnotize me and to use Rapid Transformational Therapy (RTT) knowing that by participating fully in the process and by listening to my personalized recording for 21 days I will play an important role in my overall success. 
 

Guarantee
 

I understand that although Rapid Transformational Therapy has an incredibly high success rate, Catherine Jenkins cannot and does not guarantee results since my own personal success depends on many factors that Catherine Jenkins cannot control over, including my willingness and desire to affect the changes inside of myself.
 

Audio Recording(s)
 

I give Catherine Jenkins full permission to make audio recordings that may include my voice. I understand that if a recording (or recordings) are made during or after my session(s), Catherine Jenkins retains full copyright over any forms of media that may be produced and distributed to me. 
 

Deepening Process (in-person)
 

I hereby grant permission to Catherine Jenkins to respectfully lift my arm, touch my shoulder, or rock my head during my Rapid Transformational session(s) in order to help facilitate the deepening process.

 

Confidentiality

 

By agreeing to this policy, I consent that Catherine Jenkins may release information to a specific individual or agency if it has been determined that a child or elder is at risk of or is currently being abused; if I, as a client, am in imminent danger to myself or others; or if a subpoena of records has been requested. I also understand that, at any time, Catherine Jenkins may discuss aspects of my case with other colleagues keeping my full name and identity completely confidential unless I have given permission otherwise. 
 

Cancellation


Please read our cancellation policy. 

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