DISCLAIMER:
Client Acknowledgement: By making an appointment, I consent and agree to this disclaimer as set out below.
Liability
I, The Client, hereby release Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy, from any liability or claims that could be made against him concerning my mental and/or physical well-being, including or up to death, during the work that has been outlined and agreed upon now or in the future.
Scope of Practice
I understand that Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy is not a licensed physician, psychologist, or medical practitioner and that hypnotherapy should not be considered a replacement for the advice and/or services of a psychiatrist, psychologist, psychotherapist, or doctor.
Participation
I give Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy full permission to hypnotize me and to use Rapid Transformational Therapy® knowing that by participating fully in the process and by listening to my personalized recording for 21 days, I play an important role in my overall success.
Guarantee
I understand that although Rapid Transformational Therapy® has an incredibly high success rate, Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy cannot and does not guarantee results since my own personal success depends on many factors that Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy has no control over, including my willingness and desire to effect the changes inside myself.
Audio Recording(s)
I give Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy full permission to make audio recordings that may include my voice. I understand that if a recording (or recordings) is made during or after my session(s) Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy retains full copyright over any forms of media that may be produced and distributed to me.
Deepening Process
I hereby grant permission to Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy to respectfully lift my arm(s), touch my shoulder or hands, and/or tap or rock my head during my Rapid Transformational Therapy® session(s) in order to help facilitate the deepening process.
Confidentiality
By signing this form, I consent that Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy may release information to a specific individual or agency if it has been determined that a vulnerable person (child or adult) is at risk; if I, as a client, am in imminent danger to myself or others; or if a Subpoena of Records has been requested.
I also understand that, at any time, Lars Tyler Baldwin and Wellness Within Medical Hypnotherapy may discuss aspects of my case with other colleagues, articles, books, or media for purchase or consumption, while keeping my full name and identity completely confidential.
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