Sample Client Bill of Rights copyright © 2003, National Guild of Hypnotists
Italicized sections are instructions to the writer to show where the document should be personalized. Contact Information: My name is (give the name you wish to be known by professionally). I can be
contacted through my office (list your address) or by telephone at (give your business telephone number).
Education and Training: I was trained in hypnotism at (List the name of your school or training program; if the school was state approved, say so.). I am a Certified Member of the National Guild of Hypnotists and I do annual continuing education to maintain my training at a high level. The National Guild of Hypnotists is the oldest and largest hypnotism organization in the world and its certification is the most widely recognized credential for the professional practice of the hypnotic arts. Here you would list your degree if you mention a higher degree when offering services to the public. If your degree is accredited say: “My highest degree is in [state field of study] and is accredited by an agency recognized by the United States Department of Education.” If your degree is an alternative degree, say “My degree in [state the field of study] is an alternative degree earned through intensive distance learning.”
Notice: AS THE STATE OF (State name) HAS NOT ADOPTED EDUCATIONAL AND TRAINING STANDARDS FOR THE PRACTICE OF HYPNOTISM, THIS STATEMENT OF CREDENTIALS IS FOR INFORMATIONAL PURPOSES ONLY. Hypnotism is a self-regulating profession and its practitioners are not licensed by state governments. I am not a physician nor a licensed health care provider and may not provide a medical diagnosis nor recommend discontinuance of medically prescribed treatments. If a client desires a diagnosis or any other type of treatment from a different practitioner, the client may seek such services at any time. In the event my services are terminated by a client, the client has a right to coordinated transfer of services to another practitioner. A client has a right to refuse hypnotism services at any time. A client has a right to be free of physical, verbal or sexual abuse. A client has a right to know the expected duration of sessions, and may assert any right without retaliation. (This section should be in bold print with the first sentence in capitals.)
Redress: I am a certified member of the National Guild of Hypnotists, and practice in accordance with its Code of Ethics and Standards. If you have a complaint about my services or behavior that I cannot resolve for you personally, you may contact the National Guild of Hypnotists at P.O. Box 308, Merrimack, NH 03054-0308, (603) 429-9438, to seek redress. Other services than my own may be available to you in the community. You may locate such providers in the telephone book.
Fees: The charge for my services are (list fees). You will be given (state number) days notice of any change in fees. (You can also list here any other business policies you have that concern fees, such as a cancellation charge, whether you take insurance or credit cards, etc.)
Confidentiality: I will not release any information to anyone without a written authorization from you, except as provided for by law. You have a right to be allowed access to my written record about you.
Insurance: I suggest you think of my services as something that you will pay for personally. That will both protect your privacy and help you value the work you are doing more. In general, insurance companies do not like to cover hypnotic services, and I caution you not to expect them to do so.
My Approach: (Write a brief paragraph here that explains your theory of why hypnotism is effective and about how you use it. Be sure that what you actually do with a client is a good match for what you say here. However keep this section broad and general. It should be more a statement of your overall philosophy than a list of specific techniques.)
Client Signature: I have received and read this Client Bill of Rights and understand what I have read.
Print Client Name: Client Signature: Date: