Client Bill of Rights
Contact Information:
My name is Gary Cole. I can be
contacted through my office at 701 S. Rte. 73 Ste. D, West Berlin 08091,
OceanPinesHypnosis@gmail.com, or by telephone at (856) 650 -7335.
Education and Training: I was trained in hypnotism at
Academy of Professional Hypnosis a curriculum approved by the New Jersey State Department
of Education. I am a certified Member of
the National Guild of Hypnotist and I do annual continuing education to
maintain my training at a high level.
The National Guild of Hypnotist is the oldest and largest hypnotism
organization in the world and its certification is the most widely recognized
credential for the professional practice of the hypnotic arts. My bachelor's
degree is in the field of engineering and is accredited by an agency recognized
by the United States Department of Education.
Notice: AS THE STATE OF NEW JERSEY
HAS NOT ADOPTED EDUCATIONAL AND TRAINING STANDARDS FOR THE PRACTICE OF
HYPNOTISM, THIS STATEMENT OF CREDENTIALS IS FOR INFORMATIONAL PURPOSES
ONLY. Hypnotism is a self-regulating
profession and its practitioners are not licensed by state governments. I am neither a physician nor a licensed
health care provider and may not provide a medical diagnosis nor recommend
discontinuance of medically prescribed treatments. If a client desires a diagnosis or any other
type of treatment from a different practitioner, the client may seek such
services at any time. In the event my
services are terminated by a client, the client has the right to coordinated
transfer of services to another practitioner.
A client has a right to refuse hypnotism services at any time. A client has a right to be free of physical,
verbal or sexual abuse. A client has a
right to know the expected duration of sessions, may assert any right without
retaliation.
Redress: I am a certified member of the
National Guild of Hypnotist, and practice in accordance with its Code of Ethics
and Standards. If you have a complaint
about my services or behavior that I cannot resolve for you personally, you may
contact the National Guild of Hypnotist at P.O Box 308, Merrimack, NH
03054-0308, (603)429-9438, to seek redress.
Other services than my own may be available to you in the
community. You may locate such providers
on the internet.
Fees:
The charge for my services is One Hundred dollars per hour. You will be given 30 days' notice of any
change in fees. I do not take insurance
payments. I take checks, debit card swipes and credit card payments. Please
give me 24 hours' notice if you cannot make our scheduled meeting.
Confidentiality: I will not release any information
to anyone without a written authorization from you except as required by
law. You have a right to be allowed
access to my written record about you.
Insurance:
I suggest you think of my services as something that you pay for
personally. That will both protect your
privacy and help you value the work you are doing more. In general, insurance companies do not cover
hypnotic services, and I caution you not to expect them to do so.
My Approach: You have two active minds: your
conscious and your unconscious. The
conscious mind is what gives you identity and purpose. The unconscious mind usually executes your
actions to support your conscious mind.
Sometimes the unconscious strategies are at odds with the conscious
identity and purpose. Hypnotism is a way
to communicate to the unconscious mind strategies and methods consistent with
the conscious minds purposes and I help the conscious mind see or hear
solutions the unconscious mind is presenting.
Client Signature: I have received and read this Client
Bill of Rights and understand what I have read.
Print Client
Name: ____________________________Client Signature:
________________________ Date