Client Disclosure Form

Nature of Services

VRishi Immersive Hypnotherapy offers three service lanes under California Business & Professions Code § 2908:

Lane 1 — Self-Improvement Hypnosis: Avocational or vocational self-improvement services including relaxation, confidence, habit change, motivation, performance, public speaking, sleep improvement, weight-management support, and personal growth. These services are not medical, psychological, or psychiatric diagnosis or treatment.

Lane 2 — Education & Training: Instruction in self-hypnosis and personal-development techniques, including guided self-hypnosis training, workshops, and coaching in relaxation, stress management, habit change, and performance enhancement. Not medical or psychological treatment.

Lane 3 — Referral-Based Hypnotherapy: Hypnotherapy services for medical or psychological purposes are available only upon referral from a licensed physician, dentist, or psychologist, where applicable. Written referral documentation is required before these services.

I am not a licensed physician, psychologist, psychotherapist, dentist, or psychiatrist. I do not diagnose or treat medical or psychological conditions. Services are alternative or complementary to state-licensed healing arts services and are not licensed by the state of California.

Theory Upon Which These Services Are Based

These services are based on the theory of mind taught by the Hypnosis Motivation Institute, developed by John G. Kappas, Ph.D.

That theory holds that the mind operates on two levels. The conscious mind handles reasoning, willpower, and analysis. The subconscious mind holds habits, associations, emotional patterns, and protective responses learned over a lifetime. Between them sits what the theory calls the critical mind — a filter that compares new suggestions against existing beliefs and tends to reject those that conflict.

The theory proposes that lasting change is difficult through willpower alone because willpower operates at the conscious level, while the pattern being changed is held subconsciously. Hypnosis is understood as a naturally occurring state of focused attention and heightened suggestibility in which the critical filter is temporarily relaxed, allowing goal-oriented suggestions — agreed with you in advance — to be accepted more readily.

The theory further holds that people respond to suggestion in different ways, broadly described as physical and emotional suggestibility, and that suggestions are most effective when matched to an individual's style and to their preferred way of processing information (visual, auditory, or kinesthetic). Part of your first session is spent identifying your pattern so the work can be tailored to you.

You remain aware and in control throughout. You can end a session at any time, and no suggestion that conflicts with your values will be accepted or acted upon.

This is a theory of self-improvement practice, not a medical or psychological theory. It is not a diagnosis, and it is not a claim that hypnosis treats or cures any medical or psychological condition.

Client Rights

• You may terminate a session at any time.
• You will not be asked to do anything that conflicts with your values.
• All session content is confidential.
• You are always in control during hypnosis.
• Hypnotherapy is voluntary and collaborative.

Acknowledgement

By proceeding with hypnotherapy services, you acknowledge that you have read and understood this disclosure. A signed copy will be provided for your records and retained for a minimum of three years per CA B&P Code 2053.6.