QHHT Intake, Waivers, Agreements, and Policies

Please review the information below carefully. By booking the session, you are agree to fill out the intake and sign the Waiver, Agreements and Policies after you book your session. By booking the session, you agree to the terms. You can find those documents on the Booking Page HERE or here: https://cdn.shopify.com/s/files/1/1748/1217/files/QHHT_Quantum_Hypnosis_Client_Intake_and_Agreement.pdf?v=1670105941

 

 

I understand and/or agree that:

  • I give permission for Agnieszka “Angie” Navarrete to use session material in print and/or discussion. If Agnieszka “Angie” Navarrete uses the information in print and/or discussion, it will not be used in conjunction with my name or personal identifying information without my further written permission.
  • Minimum non-refundable deposit of $100 is required to schedule the session. The remainder of the cost is due prior to the session. Alternatively, I will set up a payment plan via the website prior to the session.
  • I am participating in this hypnosis session by my own choice because I want to be here.
  • That I am not a patient, but a partner in my hypnosis experience.
  • My experience depends on my level of openness, communication and trust.
  • Any coaching and/or suggestions that may be made during this session are only informative and a part of a personal and/or educational or motivational purposes. Agnieszka “Angie” Navarrete is not a medical or mental health care professional and that she does not diagnose nor treat any type physical or mental condition.
  • The hypnosis session is exclusively for educational or informational purposes. It is not intended to be in any way used as medical or psychological advice as this can be only given by a medical professional or a mental health specialist.
  • Hypnosis is not intended to cure any specific condition. Agnieszka “Angie” Navarrete makes no claims of a cure for any disease or condition.
  • If I receive information from my Higher Self (Soul, Subconscious, Higher Consciousness, etc.) in regards to any changes in my health protocol, I take full responsibility for those suggested changes and will take it upon myself to consult my health care provider/doctor if necessary.
  • Hypnosis is not a substitute for medical interventions, body therapy, or psychotherapy. 
  • Information that comes through me is coming from me and my own Higher Self (Soul, Subconscious, Higher Consciousness, etc.).
  • My progress is my responsibility and involves how I care for myself physically, mentally, emotionally and spiritually.
  • Individual results may. Each session is unique and its success depends on the client’s full cooperation and faith in the process.
  • During the interview process, we’ll be discussing personal matters of my life, my belief systems, health history, my childhood and other issues that may have an influence on my well-being, including possible traumas. Agnieszka “Angie” Navarrete is not responsible nor will she be held responsible for any perceived negative consequence or result of any kind which is claimed to result from my participation in the hypnosis session.
  • The session will be digitally recorded. I understand that Agnieszka “Angie” Navarrete does not guarantee that the recording will be audible, fully intact, or usable. I will not hold Agnieszka “Angie” Navarrete responsible for any possible malfunctions during the recording process.
  • Facial obstructions including coverings of face or mouth will not be permitted during the session. I understand that it’s important that I can be clearly heard without any obstructions over my face or mouth.
  • I will provide Agnieszka “Angie” Navarrete with a list of questions to ask during the hypnosis session.
  • The session is one on one meaning that observers, including children, are not permitted.
  • I will arrive to the session clean and showered.
  • I will not use fragrances before or during the session.

 

____ (Initial) I agree to notify Agnieszka “Angie” Navarrete ahead of the hypnosis session of any pre-existing medical or mental health conditions or injuries. I understand that hypnosis is not suitable for certain mental health conditions such as psychosis or schizophrenia.

 

____ (Initial) I understand and agree to listen to the recording at least once within three days of receiving the recording (if applicable).

 

Cancellations, Rescheduling, No-Shows and Late Arrival Policy and Refunds

 

My signature below also indicates that:

  • I agree to the cancellation, no-show and late arrival policy of Agnieszka “Angie” Navarrete and Moon Lotus Rising.
  • I understand that Agnieszka “Angie” Navarrete and Moon Lotus Rising require a 7 day cancellation notice.
  • I understand that if I’m late to the appointment the hypnosis session cannot be extended beyond the originally allotted time and may be cancelled. We start the session promptly as scheduled. Late arrival beyond 30 min may result in a cancellation of my appointment and I may need to reschedule.
  • Should there be an emergency beyond my control (earthquake, flooding, accident, contagious illness etc.) where I need to reschedule my appointment no later than on day of my appointment, there will be no cancellation fee.
  • I understand that situations where that is a lack of preparation on my behalf are not true emergency situations and will result in a late cancellation fee of $100. I understand that in those situations, I will not be able to reschedule, I will be refunded any other payments made, and I will have to re-purchase the session.
  • I understand that the non-refundable deposit of $100 includes allows me to reschedule once with a minimum notice of 7 or more days.
  • Should I forget or consciously choose to forgo my appointment, it will be considered a “no-show”. In this case a fee from your non-refundable deposit of $100 will be applied.
  • I understand that if I use a third party to arrange a payment plan for my session, a refund will not be applied until the funds are received from the third party.

 

Inappropriate Behavior

I understand that:

____ (Initial) – Agnieszka “Angie” Navarrete can end sessions early due to any inappropriate actions, advances or hostile behavior made towards her. I those situations, the session will end promptly, and no refunds for the session will be given.

 

       ____ (Initial) By signing this document, I understand and agree on behalf of myself, my dependents, heirs, administrators, legal representatives, and assigns, to release and hold harmless Agnieszka “Angie” Navarrete and Moon Lotus Rising from any and all liability for any possible known and unknown side effects, illness, injuries, or death, and for any losses or damages relating thereto, however occurring, in relation to my participation in or information received in the hypnosis session.

 

My signature below indicates that I have carefully read and reviewed this Document including any Agreement, Waivers & Releases, Cancellations, Rescheduling, No-Shows and Late Arrival Policies Inappropriate Behavior. I fully understand and agree to all of its terms and conditions. This document remains valid unless I revoke it in writing.