Please complete this form before your first hypnotherapy session.

The information requested in this form is the minimum considered necessary for ensuring safe treatment. There is a longer form you can fill out if you wish to give more information.

A word version of this form is available from katiegerrard@heidhypnotherapy.com

Permission to store information related to yourself and your treatment allows me to make notes which helps me plan each session. It will be held according to GDPR regulations.

You can find the Hypnotherapy Agreement here