hypnotherapy consent form

Last updated: 13 Nov 2025

 The Black Swan Mindset — Healing Harmony LTD 

Please read the information below carefully. By submitting this form, you acknowledge that you understand and agree to the nature of hypnotherapy and give consent to participate in sessions offered by Healing Harmony LTD (trading as The Black Swan Mindset).

 Hypnotherapy is a therapeutic technique that uses guided relaxation, focused attention, and positive suggestion to support emotional well-being, behavioral change, and subconscious realignment.
It is a collaborative process, and you remain in control at all times. 

 You understand that:

• Hypnosis is a natural state of focused awareness.
• You cannot be made to do anything against your will or values.
• You may recall all or part of the session, and you may emerge at any time if necessary.
• Results vary from person to person and cannot be guaranteed.

 Hypnotherapy provided by The Black Swan Mindset is:

• Complementary to, not a replacement for, medical or psychological care.
• Not intended to diagnose, treat, or cure medical conditions.
   

You agree to continue any treatment or medication prescribed by your GP or mental health professional.

 To ensure safety, hypnotherapy is not suitable for individuals with:

• Psychosis or psychotic disorders
• Schizophrenia
• Severe personality disorders
• Untreated bipolar disorder
• Unmanaged epilepsy or narcolepsy
• Alcohol- or drug-induced psychosis
• Active suicidal ideation
• Cognitive impairment that affects informed consent
   

You confirm that you do not have any of the conditions listed above, or — if you do — you have obtained written approval from your GP or mental health provider.

 All information shared during sessions is confidential and stored securely in line with:

• Data Protection Act 2018
• UK GDPR
• ICO requirements
   

Exceptions apply only if:

• There is risk of serious harm to yourself or others
• There is disclosure of criminal activity where the law requires reporting

 You agree that:

• Sessions may take place via Zoom.
• You are responsible for having a quiet, safe, and private environment.
• You will not record the session unless mutually agreed in writing.
   

 You agree to:

• Engage with the process to the best of your ability
• Follow any exercises, practices, or reflective work suggested outside sessions
• Disclose relevant information about your physical or mental well-being
• Avoid alcohol or recreational drugs 24 hours before a session

• All sessions are paid in full at the time of booking.
• You may reschedule with 24 hours’ notice.
• Sessions cancelled with less than 24 hours' notice or missed without notice are non-refundable.
• Digital products are non-refundable due to their instant-access nature.
   

(See full Terms & Conditions on the website.)

 By signing/submitting this form, you declare that:

• You are over 18 years of age.
• You have read, understood, and agree to the Hypnotherapy Consent Form.
• You agree to the Terms & Conditions, Privacy Policy, and Cookies Policy of Healing Harmony LTD.
• You understand the limits of confidentiality and the scope of practice.
• You voluntarily consent to receive hypnotherapy from The Black Swan Mindset.
• The information you have provided is true and complete.