First Name

Last Name

Date of birth

Phone *

Email *

Fees: The initial consultation is free. My service fees are then £150 for regular sessions, unless otherwise discussed. Regular sessions will last approximately one hour. Payment is due in full 48 hours before the time of the session unless otherwise arranged.

Cancellation Policy: Your appointment time is reserved exclusively for you. Please arrive promptly to obtain your full session. If you must cancel or reschedule, I require a 48-hour notice. Unless cancelled prior to 48 hours, you are financially responsible for 50% of the scheduled fee. If you must cancel or reschedule due to an emergency, please notify me as soon as possible.

Notice: Hypnosis is a natural and safe, self-help process. Hypnotherapy is not the practice of medicine. The hypnotherapy services provided are for educational and self-improvement purposes and are not intended for the diagnosis or treatment of any medical or psychological condition. If you have an ongoing medical illness, mental disability or mental illness, please consult a medical doctor, psychiatrist or psychologist.

Redress: I offer hypnosis services in accordance with the Code of Ethics and Standards prescribed by the International Hypnotherapy Association and The British Society of Clinical Hypnosis . It is your right to refuse any aspect of my service and to seek the services of another hypnotherapist at any time.

All hypnosis sessions are confidential. I have 3 tiers for confidentiality, please identify what level of confidentiality is required.:

I will not release any information to anyone without written authorisation from you, except as provided by law.

As I am a Teacher of Clinical Hypnotherapy I may use your case to further my research and or for training purposes. All identifiable information will be removed. And full consent will be requested prior to use.

I am able to request a review from you on social media, website or on search engine platforms.

By checking this box, I consent to receive transactional messages related to my the services I have requested. These messages may include appointment reminders, and updates from my practice. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.

By checking this box, I consent to receive marketing and promotional messages, including special offers, discounts, new product updates among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.

Client Consent and Release: I am of legal age and in consideration of my acceptance as a participant in hypnosis and hypnotherapy sessions, training, seminar or any other services with Amanda Joy

I declare that I have listened to or read this consent form and release, and that I fully understand and agree to the terms described.

Client Signature (If under 18, must be additionally signed by legal guardian)

Clear