Disclosure Statement, Terms of Engagement  & Consent Agreement

 

Contact Information:  My name is Su Ricks. I can be contacted via New Stone House, Church Street, Charwelton, Northants, NN11 3YT.  Tel  01327 263355.

Email:  su@nsholistic.co.uk

Web: http://www.nsholistic.co.uk

 

Education and Training: I received my initial training in hypnotherapy through the Washington School of Clinical and Advanced Hypnosis where I obtained the Diploma in Clinical and Advanced Hypnosis.  I am also a certificated NLP Practitioner.  I also hold the National Diploma in Hypnotherapy which is an independently verified qualification, accredited through NCFE equivalent to an NVQ level 4. I hold a BA degree History and Social Biology from the University of Reading and am a qualified holistic therapist, trained in massage, aromatherapy and specialising reflexology.  Prior to becoming a hypnotherapist, I was a business consultant with a large corporate organisation, specialising in flexible working and change management for over 6 years and a project manager specialising in organisational development for some 12 years prior to this.

Notice: The United Kingdom has not adopted any educational and training standards for the practice of hypnotherapy. This statement of credentials is for informational purposes only.

 

Confidentiality: I will not release any information to anyone without a written authorisation from you, except as provided by law. You have a right to be allowed access to my written record about you.

 

Redress: I am a Registered (MNCH Reg) member of the National Council for Hypnotherapy and practice in accordance with its Code of Ethics and Standards. If you ever have a complaint about my services or behaviour that I cannot resolve for you personally, you may contact the National Council for Hypnotherapy at PO Box 421, Charwelton, Daventry, NN11 1AS Tel: 0800 952 0545, or via the website: http://www.hypnotherapists.org.uk.  You should be aware that I work for this organisation on a part time basis and was elected by the members as the Executive Director in June 2006.

 

Fees:  My fees are £50 per hypnotherapy session and £100 for One Session Smoking cessation.  Payment may be made by cash or cheque ( payable to S Ricks), or by Credit or Debit Card via PayPal (no account required), details to be entered online during the appointment. Appointments cancelled without 24 hours notice will be charged for in full.

 

My Approach: Please note that I am not able to able to guarantee the outcome of your sessions.  I use a brief and results focussed approach, in which I attempt to minimise the number of hypnotherapy sessions required for the optimum outcome, although you should be aware that it is not possible to guarantee 100% success with any treatment undertaken.

You may at some point be given a cd for personal use and it is highly recommended that you listen to this as directed.

 

Client Signature: I have read this statement and understand what I have read.

 

Client Name (Print):

 

Client Signature:                                                                        Date