New Client Forms

In addition, the following forms will need to be completed during your initial visit including, Disclosure of Services, Acknowledgement of Services and Fees, and in the event you have been referred to Hypnotic Therapeutics by a licensed medical practitioner, the Request For Medical Referral Form.  These forms are fairly simple and not too time consumiong to complete.

The forms are necessary in order to obtain the appropriate information to assist us with assisting you.  So that we may spend the time we have scheduled wisely and adequately to address your needs , please have these forms completed prior to your appointment.  If you should have any questions, please contact us.  Thank you.

Hypnotic Therapeutics – New Client Intake Form

Hypnotic Therapeutics – Life History Questionnnaire

Hypnotic Therapeutics – Disclosure of Services

Hypnotic Therapeutics – Acknowledgement of  Services and Fees

Hypnotic Therapeutics – Request For Medical Referral Form

Hypnotic Therapeutics – Parental Consent Form

Hypnotic Therapeutics – Consent To Release Information

**You must bring the forms with you at the time of your initial consultation.

***Consent to Release Information and Parental or Custodial Consent forms only need be completed for minor children.