Liability
I hereby release Anne Margaret Carioti from any liability or claims that could be made against her concerning my mental and/or physical well-being during the work that has been outlined and agreed upon (now and in the future) by filling out this form.
Scope of Practice
I understand that Anne Margaret is not a licensed physician, psychologist, or medical practitioner of any kind and that hypnosis should not be considered a replacement for the advice and/or services, of a psychiatrist, psychologist, psychotherapist, or doctor.
Participation
I give Anne Margaret 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, Anne Margaret cannot and does not guarantee results since my own personal success depends on many factors that Anne Margaret has no control over, including my willingness and desire to affect the changes inside of myself.
Audio Recording(s)
I give Anne Margaret full permission to make audio recordings that may include my voice. I understand that if a recording (or recordings) are made during or after my session(s) Anne Margaret retains full copyright over any forms of
media that may be produced and distributed to me.
Deepening Process
I hereby grant permission to Anne Margaret to respectfully lift my arm, touch my shoulder, or rock my head during my Rapid Transformational session(s) in order to help facilitate the deepening process if in person.
Confidentiality
By signing this form, I consent that Anne Margaret may release information to a specific individual or agency if it has been determined that a child or elder is at risk of or is currently being abused; 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, Anne Margaret may discuss aspects of my case with other colleagues keeping my full name and identity completely confidential always unless I have given permission otherwise.
All services offered by Anne Margaret LLC (Therapy) are subject to the above. Holistic practices and the like are considered a positive form of entertainment and not a a substitute for any medical profession.
Anne Margaret
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