BEFORE YOUR FIRST SESSION
*******************READ FIRST BEFORE YOU OPEN THE INTAKE FORM*******************
You can fill out the intake form in your computer but it all begins with clicking the button up above, but read these instructions before you click the button. After you click the button the intake form will open up, go to the right-hand corner of the form and click download icon or button. When you do it will ask if you want to open it or save it. "OPEN" the document using Adobe PDF reader. When you click that it will open up in a PDF activated form and you can fill it it out on your computer. Once you fill it out save the filled out intake form to your computer and then email it to me as an attachment. It's that easy. Let me know if you have any issues.
I look forward to meeting with you.
Wayne, Master Hypnotist
What Client Should Expect?
Because you have decided to become a client of mine, I owe you some things:
You should expect me as your hypnotist to schedule appointments and live by them.
You should expect me as your hypnotist to worry about "you" at a higher level than you worry about yourself, as if you were a member of the family.
You should expect me as your hypnotist to perform at such a level of professionalism that the work will be superlative and endure.
You should expect me as your hypnotist to be respectful.
You should expect me as your hypnotist to be well trained and current.
You should expect me as your hypnotist to speak to you in plain English and not use jargon.
You should expect me to explain anything you do not understand clearly, and to answer any and all questions with patience and understanding.
Although I do not diagnose nor prescribe or tell people what to do, in the course of our sessions together, I suggest, educate, motivate and inspire people to get well. I do not provide physical or mental therapy. I am not a doctor or psychological counselor. Any suggestions or advice are general and should not be interpreted as a substitute for consulting with medical or mental health professionals. Accordingly, I take no responsibility for the consequences of any actions you might decide to take based on any comments or opinions I may express in the course of your visit.
Client Bill of Right
Education and Training: I was trained in hypnotism at Hypnosis Motivational Institute located in Tarzana, California. This school is an accredited school for hypnosis. I am a Certified Member of the National Guild of Hypnotists and I do annual continuing education to maintain my training at a high level. The National Guild of Hypnotists is the oldest and largest hypnotism organization in the world and its certification is the most widely recognized credential for the professional practice of the hypnotic arts.
Notice: AS THE STATE OF TEXAS HAS NOT ADOPTED EDUCATIONAL AND TRAINING STANDARDS FOR THE PRACTICE OF HYPNOTISM, THIS STATEMENT OF CREDENTIALS IS FOR INFORMATIONAL PURPOSES ONLY.
Hypnotism is a self-regulating profession and its practitioners are not licensed by state governments. I am not a physician or a licensed health care provider and may not provide a medical diagnosis nor recommend discontinuance of medically prescribed treatments. If a client desires a diagnosis or any other type of treatment from a different practitioner, the client may seek such services at any time. In the event my services are terminated by a client, the client has a right to coordinated transfer of services to another practitioner.
A client has a right to refuse hypnotism services at any time. A client has a right to be free of physical, verbal or sexual abuse.
A client has a right to know the expected duration of sessions, and may assert any right without retaliation.
Redress: I am a certified member of the National Guild of Hypnotists, and practice in accordance with its Code of Ethics and Standards.