Client Forms

Intake & Disclosure

Complete your forms online or download PDFs to print, sign, and return before your session. All information is confidential.

Client Forms

Client Disclosure & Informed Consent

Required

Required before any services. Explains the scope of hypnotherapy, what to expect, and your rights as a client under California law.

Acknowledgement of Services & Fees

Required

Confirms session fees, 24-hour cancellation policy, and recording consent. Signed before any paid session.

Application for Hypnotherapy Services

Required

Your intake form — contact info, goals, health background, and anything that helps us prepare for your first session.

Life History Questionnaire

Required

A comprehensive background questionnaire to help your practitioner understand your full picture — family, relationships, health, and life experiences. Complete at your own pace before your first session.

Release of Liability and Assumption of Risk

Required

Acknowledges the nature of hypnotherapy services, assumes responsibility for participation, and releases the practitioner from liability. Select Pro Bono or General version inside.

Consent to Release Confidential Information

Only needed if you would like us to communicate with your physician, therapist, or another provider on your behalf.

Parental Consent

Required

Required for all clients under 18 years of age. Must be signed by a parent or legal guardian before any services can begin.

Pro Bono Acknowledgement of Services

Required

Required for all clients receiving complimentary sessions through the community service program. Replaces the standard fees form.

Practitioner & Referral Forms

These forms are used by the practitioner for clinical documentation and professional communication. They are provided here for reference.

Clinical Intake Form

Practitioner-only guide for documenting client case number, chief concern, and clinical observations during the intake session.

Medical Professional Notice (California)

Letter to a client’s physician notifying them of hypnotherapy services and requesting confirmation that services are not contraindicated.

Psych Professional Notice (California)

Letter to a client’s psychologist or counselor notifying them of concurrent hypnotherapy services, per California requirements.

If you booked via PocketSuite, the required forms are included in your booking flow. If you booked via Calendly or phone, please complete the required forms here before your session.