Notebook

Client Intake Form

Just a few things to go through before we start

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IN-Person Session Covid-19 Health Declaration

Required for In-clinic sessions (Online clients may skip)

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Client intake form

Before we can see you, we just need you to fill out a bit of information to help us help you better.

 

Our Conditions of Service 

 
 

Keeping you informed of our policies

Fees: Our general adult service fees, including our individual session pricing, concession pricing, Child (under 16) pricing and “bundles” that cover 2-4 sessions costs are listed on our website. Discounted concession session fees require proof of government concession required). Services can be paid either in a single payment prior to treatment, or in regular mutually agreed instalments as stated in the customised “pay by the week agreement” form.  A session may last 30 minutes to 1 hour and 30 minutes depending on the hypnotists individual session plan or discretion. 

Payment must be made prior to the formal hypnotic treatment (in-clinic) If the payment process has not been completed via our website when booking the appointment. Payment for any additional sessions (if required) will be taken at the start of any session. No treatment will commence until the session (or bundle of sessions) has been paid in full, or payment plan initiated. Payment plans require a Visa or MasterCard labeled credit or debit card. When paying on a payment plan HDH also passes on the 2.2% merchant fee to the client on top of the standard session rates.

By booking a session with HDH Clinical Hypnotherapy, you are stating you agree to all of the above, and to pay our listed fees for your service, on time and in full, and that non/late payment will in-cure $8 per an invoice reissue fee, per an invoice payment request issued (maximum 1 invoice reissue per day). In addition, you also agree to pay any and all costs involved in-cured by Brad Talbot and HDH Clinical Hypnotherapy in collecting the previously mentioned service fees (this includes, but its not limited to legal/debt collector costs/fees). 

Cancellation Policy: Your appointment time is reserved exclusively for you. Please arrive promptly to obtain your full session. If you must cancel or reschedule, we require a 24 hours notice, as late cancellation will prevent us from helping others. Because of this, you are financially responsible for 100% of the scheduled fee if you do not show up for an appointment or, a cancellation occurs within 24 hours of your scheduled time. If you must cancel or reschedule due to an emergency, please notify us as soon as possible. HDH holds the right to reschedule an appointment, without reason, to an alternate, mutually agreed upon time and date. A cancelled or missed appointment will be considered as an attended and completed to clients under a payment plan.

Confidentiality: All hypnosis sessions and client information are confidential. All hypnotherapy sessions are digitally video recoded and documented. We will not release any recorded information to anyone without written authorisation from you, except when required by state or federal law, or in the case of civil legal proceedings. Session recordings are available to the client, by request (as long as the integrity of the recordings is preserved). Corrupted video/audio files do sometime occur and are out of HDH's control, and may prevent a client from receiving a requested file. HDH Clinical Hypnotherapy holds the right to offer a copy of the recording(s) in a fair and reasonable time frame. Session recordings are destroyed (5) years after treatment is completed.

 

If you disclose that you have committed certain criminal offences, the therapist is obliged by law to report you to the authorities. You further understand that if the therapist deems that you may be a physical threat to themselves, yourself, or others, that the Therapist is obliged to report this.

Please note: Hypnosis is a natural and safe, self-help process. The hypnotherapy services provided are for educational and self improvement purposes and may include evocative communication, and are not intended for the diagnosis of any medical or psychological condition. If you have an ongoing medical illness, mental disability or mental illness, it is your obligation to consult  a medical doctor, psychiatrist or psychologist prior to seeing us. 

Physical Contact: Physical contact may be made during sessions to your head, neck, shoulders, arms and hands, and that by signing this document, you consent to physical contact to these zones by the therapist, as part of the hypnosis process. This may also include Sexual health sessions described as "Non-Touch". The non-touch refers to areas of the body not previously stated. To clarify, there is a strict policy of avoiding contact with the erogenous zones between the client and Hypnotist.

Redress: If you should have a complaint which we have not resolved to your satisfaction, please feel free to contact the Australian Hypnotherapists Association (AHA) t 1300 55 22 54, www.ahahypnotherapy.org.au It is your right to refuse any aspect of our services and to seek the services of another hypnotherapist at any time.

The Satisfaction Guarantee: applies to anyone who has been accepted as a client by the hypnotherapist (with a mutually agreed upon goal). If you are unsatisfied with your progress after a couple of simple conditions have been met, the hypnotherapist will continue to treat you, at no extra cost, for as many sessions as it takes. They will continue to treat you until you can sit in the clinic chair and say that you no longer require the hypnotherapists services to resolve the issue. No client booking for a standard treatment will have to pay for more than 6 sessions to address an issue. Many will only need a couple of sessions to achieve the mutually agreed upon result. The guarantee requires you have received and paid for at least two (2) and up to six (6) fully paid clinical sessions to help with your initial reason for making contact with HDH. You also must complete any required homework given (if applicable). If you wish to start working on a new problem after your initial goal has been achieved, then the (6) session guarantee re-sets with the onset of work on the new area of improvement.

Release: I am of legal age and in consideration of my acceptance as a participant in hypnosis and hypnotherapy sessions, training, seminar or any other HDH Clinical Hypnotherapy service (Or as a parent or legal guardian for a child receiving aforementioned services agree on their behalf). I for myself, my heirs, executors, administrators and assignees, do hereby release and discharge HDH Clinical Hypnotherapy and Bradley Talbot or other participants from all claims of damages, copyright, demands or actions whatsoever in any manner arising from my participation. Further, I understand that audio, video and documented recordings are made during sessions, and that HDH Clinical Hypnotherapy, retains the copyright of these recordings. 

By submitting the online form you declare that:

(1) All information you submitted is accurate, and

(2) That you have read this consent and release and that you fully understand and agree to the terms as described.