POLICIES AND AGREEMENT FOR COUNCIL OF LIGHT ONLINE LEARNING CAFE
POLICIES
Any purchase for products and/or services made through our website or in person automatically gives your electronic signature to this agreement.
HYPNOSIS/LIFE COACHING/SPIRITUAL ADVISING AGREEMENT
I have been advised by Lisa Dottoli, CHt, the scope of the non-medical therapeutic Hypnotism Practice, Life Coaching and Spiritual Advising and I give my full consent to receiving Hypnosis/Life Coaching/Spiritual Advising sessions with Lisa Dottoli, CHt. Certified Holistic Health Practitioner. I understand that results vary and that the above name practitioner does not guarantee results.
Hypnosis/Life Coaching and Spiritual Advising is not a replacement for medical treatment, psychological or psychiatric services or counseling.
I also understand that the Hypnosis/Life Coaching and Spiritual Advising does not treat, prescribed for or diagnose any condition. I understand that the practitioner is a facilitator of non-therapeutic Hypnotism/Life Coaching and Spiritual Advising and is not practicing any other profession that requires a license under the laws of the state of New Jersey.
I am aware and understand that in some cases it may be necessary for the practitioner to respectfully touch my shoulders, arm, hand, wrist, or four head in order to assist me in relaxation or the awakening process. I give the practitioner permission and consent to do so in order to help me established a beneficial state of hypnosis.(Hypnosis/Life Coaching and Spiritual Advising)
I have been advised that I am free to terminate any or all sessions at any time without refunds. I have agreed to participate in each session to the best of my ability. I have accurately provided background information as requested by the hypnotist. I understand that confidentiality regarding my sessions will be honored between Lisa Dottoli, CHt and me. This same confidentiality is respected when working with minors under the age of 18.
DISCLOSURE STATEMENT
Confidentiality: matters regarding your sessions will be kept confidential except in the following circumstances: U give me specific permission to release information to a specific individual or agency; child abuse; you are an imminent danger to self or others; or in the case of the subpoena of records. Any information shared is kept Confidential. From time to time, I also consult with other colleagues, but in this circumstance, clients are not identified by name. Your signature below constitutes you giving permission for such consultations.
FEES AND PAYMENTS
The charge for hypnotherapy is $125.00 per session. Payment is due in full at the time of service by cash, credit card, or PayPal. I understand that Lisa Dottoli, CHT does not accept any form of insurance or state supplied programs at this time for any type of sessions. (does not pertain to hypnosis digital session packs)
Note: fees are subject to change without notification. The current fees will be honored for six months after your initial consultation.
Cancellations: Since I have reserved our appointment time for you, it is my policy to charge for cancellations received less than 24 hours notice.
Prepaid Sessions: the above cancellation policy also applies to any programs with prepaid sessions. Except for emergencies or bad weather, 24 hours notice is required. Failure to keep your appointment or non-emergent short notice cancellations will result in the forfeit of your prepaid session. No refunds will be given for unused prepaid sessions. All prepaid sessions are nontransferable and will expire after three months.
Reports and Phone Calls: there is no charge for brief calls. Calls lasting longer than 15 minutes will be charged to the client on a pro-rated basis. Reports requested by insurance companies, physicians, etc. Will not be released without your permission. Charges will apply to any reports necessary for insurance companies, physicians, etc.
Education and Training: I completed the Associates Degree In the Psychology program at an accredited school, SWIHA in Tempe Arizona to become a Certified Clinical Hypnotist/Natural Health Practitioner. I am also certified in ten other areas of the natural wellness field including: Domestic Violence Counseling, Hypnotherapy(2), Angel Healing, Reflexology, Reiki 1 & II, Aromatherapy and an Intuitive Master Life Coach(2).
Code of Ethics: I operate my practice in accordance with the code of ethics and standards included on this website. If you have any questions or concerns, please contact me at 856 – 245 – 7218.
Minors: appointments for children under the age of 18 require written consent from the parent or guardian. For optimum results, it is recommended that parents or guardians not accompany children in the hypnosis session. Parents and guardians may wait in the waiting room or lobby of our office while the hypnosis session takes place.
Medical Hypnosis:Hypnosis is effective in relieving some conditions (e.g. pain management, migraines, IBS, etc.) but will require a signed release from your doctor or appropriate healthcare professional to avoid masking symptoms before proper diagnosis and/or medical treatment has been obtained. Of course, non-medical issues (e.g. smoking, weight loss, confidence, self-esteem, etc.) Will not need a form.