I understand that Hypnosis is not a replacement for medical treatment, psychological or psychiatric services or counseling. I also understand that Daniyela Braunovic (Sakara Integrative Wellness LLC, "Practitioner") does not treat, prescribe for or diagnose any condition and is not acting in the capacity of a doctor, dietitian, nutritionist, or other licensed or registered professional, and that coaching, and hypnosis are not intended to replace services performed by these professionals. I understand that Practitioner is a facilitator of hypnotherapy and integrative health coaching. I give my full consent to receiving hypnosis sessions. I agree to participate in each session to the best of my ability. I understand that I am not a patient, but a co-operator in my hypnosis experience. I have accurately provided background information as requested by the Practitioner. I agree to follow all suggestions provided by my hypnotherapist, including keeping all scheduled appointments, and may also include listening to recorded sessions, practicing mental exercises and acting on lifestyle change advice. Hypnosis is an active, participatory protocol and can only succeed with my full commitment and willingness to succeed.

You are encouraged to consult with your healthcare provider or other professional care provider with any questions or concerns you may have regarding any health condition or any other condition that you may have before taking any action or engaging in any hypnosis or coaching program, included in Sakara Integrative Wellness’ services.

I use a variety of modalities including hypnotherapy and health coaching that are all intended to empower clients to connect with their inner resources.  I use hypnosis and coaching work to facilitate clients in this empowerment.  The number of appointments and courses of hypnotherapy and/or health coaching varies according to the individual needs and goals of each client.

ONLINE HYPNOSIS AND COACHING SERVICES 

I understand that services delivered via virtual means rely on several electronic, often Internet-based, technology tools. These tools can include videoconferencing software, email, text messaging, phone calls, virtual environments, and others.

Currently, Sakara Integrative Wellness provides hypnosis services using videoconferencing software including Zoom, and others as needed.

•  I understand I will need Internet access and technological tools required to use one of the above apps in order to engage in hypnosis and coaching with Sakra Wellness.
  • I understand If I have any questions or concerns about the above tools, I will address them directly to the Practitioner so we can discuss its risks, benefits, and specific application to our work.
  • I understand that I will be responsible for creating my own safe and confidential space during sessions. I understand that I should use a space that is free of other people. It is recommended that I find a place where I feel comfortable, such as a chair or couch, and ensure that my face is visible in my screen and camera.
  • I understand that at our first session, we will develop a plan for backup communications in case of technology failures.

RELEASE OF LIABILITY:  

I understand that hypnosis does not control free will, but rather works in support of my goals. I realize it is impossible to guarantee human behavior and understand that Practitioner does not guarantee results. I understand that for me to succeed, I choose to accept the responsibility of doing my part. I am solely responsible for decisions, actions, choices, lifestyle changes, and results. I agree to communicate honestly and dedicate my time and energy to participating fully in the Program.

Hypnosis is an active, participatory protocol and can only succeed with my full commitment and willingness to succeed.

Integrative health coaching and hypnosis are a comprehensive process that may involve different areas of your life, including work, finances, health, relationships, education and recreation. Deciding how to handle these issues and how to incorporate coaching and hypnosis principles into those areas is exclusively your choice.

I understand that I am free to terminate any or all sessions at any time, and realize Practitioner reserves the right to refuse service to any client.

I am of legal age and in consideration of my acceptance as a participant in this and all hypnosis sessions conducted at Sakara Integrative Wellness, LLC. I for myself, my heirs, executors, administrators and assignees, do hereby release, discharge and hold harmless Daniyela Braunovic and Sakara Integrative Wellness, LLC from all claims of damages, demands or actions whatsoever in any manner arising from or growing out of my participation.

DISCLOSURE STATEMENT 

CONFIDENTIALITY: 

Matters regarding your sessions will be kept confidential except in the following circumstances: (a) if you grant Practitioner specific permission to release information to a specific individual or agency; (b) in cases of child abuse; (c) if you express that you are an imminent danger to self or others; or (d) in the case of the subpoena of records. From time to time, Practitioner consults with other colleagues, and in this circumstance, clients are not identified by name. Your acceptance of this form below constitutes you giving permission for such consultations.

Cancellation/Rescheduling: If you need to cancel or reschedule a session, please provide at least [24/48] hours' notice. Failure to do so will result in a forfeiture of the session fee.

Refunds: Refunds are not provided.