CLIENT INTAKE FORM

***This form does not need to be completed for a FREE Phone Consultation.***



CONSULTING AGREEMENT - HYPNOTHERAPIST

In order to support you in deriving maximum benefit from our scheduled time together, I agree to:

  • Use the best of my abilities and expertise to facilitate such changes as are mutually agreed to be in your best interest and in no way harmful to you;

  • Work diligently to ensure as best I can that all suggestions given are positive in direction, beneficial in nature, and presented within a context of health and well-being;

  • Refrain from using you or your trust to satisfy any personal needs I may have outside the working relationship established here;

  • Offer you my undivided attention and professional assistance during our scheduled consultations;

  • Inform you immediately if, in my judgment, you would be better served by another professional or an alterative means of reaching your objectives.

I am professionally committed to assisting you - in the shortest possible time and at the lowest possible cost - in mobilizing your resources to achieve maximum results.


Kathleen Moore
Certified Clinical Hypnotherapist