Client Intake Form

Please answer the following questions to the best of your ability.

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I understand that Jennifer Boyle is a hypnotherapist and will be using various modalities in assisting me in reaching my goals. I understand that this is a partnership where results may vary and that my participation will be instrumental in my success. I understand that there are no expressed or implied guarantees. I am fully aware that this relationship is non-medical in nature and does not replace medical treatment. If need arises I will consult my health practitioner for services needed. I also understand that all sessions are confidential. I also understand that the practitioner will retain client intake forms and signed agreement forms for a period of 18 months after our last meeting.
Name
Do you have prior experience with hypnotherapy?