Thank you for joining me for a Whole Self treatment.
Please take a moment to complete the form below to the best of your ability, and with as much information as you can. Confidentiality will be adhered to as in the details below.
This form enables me to gain any insight to your personal goals, plus ensure suitability for certain aspects and tools that could be used, and will apply to any further hypnotherapy or mindset sessions you may have.
Please also take a moment to read the therapy contract and privacy notice at the bottom of this page.
Whole Self Consultation Form
See privacy notice and information at the bottom of the page
A beautiful journey awaits
Softness for your soul, as you embody and embrace the fullest version of you
The boring, but important, bit...
Privacy notice and information:
Thank you for trusting me with your personal information. Any information given, is strictly confidential, unless needed to be shared with concern for your welfare, or the welfare of others. Any information shared will be shared in confidence. Clare Cockell follows the guidelines of the Data Protection Act, and The National Hypnotherapy Society. This means that it is ensured client notes and records are kept secure and confidential, and confidentiality is adhered to in the most professional manor.
Clare Cockell works to the professional standards outlined in The National Hypnotherapy Society’s Code of Ethics and Conduct and not to give clause for complaint. Clients who do have a cause for complaint have access to the complaints and disciplinary procedures of The National Hypnotherapy Society, 19 Grafton Road, Worthing, West Sussex, BN11 1QT or telephone: 01903 236857, email address is [email protected], and quote name of therapist and member no: HYP19-05918.
Contact and Location of Sessions:
Clare Cockell, Cert.Hyp CS
Address: The Rose Suite, Barham Court, Teston, Maidstone, Kent. ME18 5BZ or online
Telephone: 07749119801
Email: [email protected]
The information given in the form above is to the best of your knowledge. You confirm that you are over 18 years old.
Once you have read and agreed to the above, please select the relevant option in the form for 'privacy notice'.
