Disclaimer: Hypnosis and other modalities used provide impressive results for most people but there is no guarantee it will achieve your goals or be as beneficial as it is for most people. Please consult your own physician and/or therapist regarding your participation.

I have requested services with Zeno Rossetti and Zeno Hypnotherapy LLC. I understand that Zeno Rossetti and Zeno Hypnotherapy LLC are not licensed medical doctors, practitioners or therapists. This consultation is not meant to diagnose or treat any disease, but rather it is intended to provide information that will promote the conditions under which natural healing skills and abilities are strengthened.  It is designed to give insights into innate healing potential and guide toward a more healthy and balanced lifestyle. I also realize that the sessions are for increasing coping skills, teaching how to manage stress in creative, healthy ways and to help eliminate unhealthy habits.

I certify that my participation is of my own free will, and I accept complete responsibility for my well-being at all times. I further certify that I am a healthy individual and that I am physically and psychologically fit to fully participate, and I know of no reason, nor have I been informed by my physician or psychologist of any reason, why my participation would do me harm of any nature. I agree to release and hold harmless Zeno Hypnotherapy LLC and all of it’s affiliates from any claim arising out of any portion of these sessions in which I am voluntarily participating, including any claim for physical and/or mental injury to myself, whether caused by negligence or otherwise.

I also understand that although these sessions may raise emotional issues, it is not intended to provide a therapeutic environment or be a substitute for ongoing counseling or psychotherapy. Resolution of any issues which may surface and which may warrant counseling will be my sole responsibility and will be undertaken in my sole discretion and at my own expense.  I am clear that I am not being treated for specific medical problems.

I clearly understand that all services rendered to me are to be paid in full directly before our session and non-refundable regardless of the results or any unforeseen circumstances.  I agree that all sales are final.

For further sessions I shall give the office coordinator a minimum of 24 business hours notice in the event of a cancellation.  I understand if I fail to comply, I shall be charged the amount of service scheduled.  I also take responsibility for being on time for my appointment, and I shall be charged for the full scheduled appointment time.
Hypnotherapy, Consulting & Coaching sessions are kept strictly confidential between the client and practitioner.

I, the undersigned, have read all the above paragraphs and understand and accept the policies as stated, as well as acknowledge Notice of Privacy Practices.  Payment and consideration given to Zeno Rossetti and Zeno Hypnotherapy LLC are evidence of my agreement to all of these policies.