VRishi Immersive HypnotherapyAcknowledgement of Services & Fees
Signed Before Any Fees Are Incurred

Acknowledgement of Services & Fees

Between: VRishi Hypno LLC dba VRishi Immersive Hypnotherapy (“the Provider”) and the Client named below. Practitioner: Jithendran Sellamuthu, C.MH., Certified Master Hypnotist.

Services

Services consist of guided hypnotic techniques for avocational and vocational self-improvement and instruction in self-hypnosis, as described in the Client Disclosure & Informed Consent. They are not medical, psychological, psychiatric, or dental diagnosis or treatment, and no specific outcome is promised or guaranteed.

Session Fees

ServiceDurationFee
Private Guided Session
$200
Practice Partner Session — introductory rate
$95
Pro Bono Session — community service program (limited period)
$0

Additional fees entered above at the time of signing. The initial consultation is complimentary. Pro bono sessions are provided at no charge as part of a supervised community service program for a limited period. Practice-partner sessions at the introductory rate are $95 as shown above. The standard private-session rate is $200 as shown above. Any change to these fees is agreed in writing before it applies.

Payment

Payment is due at the time of service unless agreed otherwise in writing. Accepted methods are confirmed at scheduling through the secure booking system. A receipt is provided for every payment.

Cancellations & Missed Sessions

Please give at least hours’ notice to cancel or reschedule. A session cancelled with less notice, or missed without notice, may be charged , except in emergencies.

Acknowledgement

I have read and understood this acknowledgement before incurring any fees or charges. I agree to the services, fees, payment terms, and cancellation policy stated above.

Client signature
Client name (printed)
Date
For the Provider: VRishi Hypno LLC
By: Jithendran Sellamuthu, C.MH., Member
hello@vrishihypno.com · +1 858.226.0619vrishihypno.com