I give my full consent to receiving therapy sessions from Julie Bale. I understand that results vary from person to person, and the agreement by Julie Bale to work on the issues or problems presented by me, using whatever model or models are appropriate to my situation, in no way implies or guarantees a ‘cure’ of the said issues or problems. I understand that hypnotherapy/mind training is a collaborative process, and the degree of progress is dependent on my active participation and engagement in the process.  I understand that there are no guarantees offered and that success depends on my active participation and motivation.  I understand I will need to complete tasks in between sessions. I understand that I am paying for Julie’s time and not for a guarantee of success.I understand that Hypnotherapy, or any other therapy provided is not a replacement for medical treatment, psychological or psychiatric services or the appropriate counselling.  I also understand that Julie Bale does not treat, prescribe for, or diagnose any medical or mental health condition. I declare that, if advised prior to any session to seek medical approval, I have consulted with my General Practitioner and/or Hospital Consultant and gained the appropriate medical approval for working with Julie Bale. The number of sessions required is discussed and agreed at the start and I agree to pay for any session prior to it taking place. I understand and agree that my therapy sessions will take place online or face to face and this will be agreed prior to treatment started. I am aware that if I choose to have online sessions it is my responsibility to ensure that I am in a place where I will be completely uninterrupted for the entire session. I understand that any recordings of sessions or hypnotherapy recordings either video or audio which are provided by Julie Bale are for my own personal use only and will not be shared, copied, sold to anyone else or uploaded onto any social media platform.  I agree to complete the tasks given between sessions to the best of my ability. I note that I am free to terminate any or all sessions at any time. I have agreed to participate in each session to the best of my ability, and that contact between sessions will be strictly limited to email.I have accurately and truthfully answered the questions on this form and provided background information as requested. Confidentiality is paramount and will be maintained in all but the most exceptional circumstances, which can include if there is an imminent danger to myself or others; and where there is good cause to believe that not to disclose would cause danger of serious harm to others. Most standards of confidentiality applied in professional contexts are based on the Common Law concept of confidentiality where the duty to keep confidence is measured against the concept of ‘greater good’. The sharing of anonymous case histories with supervisors and peer-support groups is not a breach of professional confidentiality. The sharing of open case histories with supervisors and any referring NHS medical practitioner is also not a breach. PLEASE NOTE:  Julie Bale reserves your sessions for you and it is her policy to charge the full fee for cancellations received with less than 48 hours’ notice, or non-attendance. By ticking the box below, you agree to this.