I am perfectly aware that Shahira Galal will be the person conducting my session.

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Shahira Galal is a certified Introspective Hypnosis practitioner, she is neither a physician nor a psychiatrist, and she will not diagnose nor treat any type of physical or mental disorders.

I fully understand that the hypnosis sessions are for emotional enrichment, personal development and spiritual growth.

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I understand not to stop any prescription psychiatric medication without referring back to my physician.

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I also understand that any suggestions made during my session are based on informational character and part of my personal and development path.

I understand that any personal information shared in my session is protected under practitioner/ client confidentiality.

 

I am willing to be guided through relaxation, visual imagery, hypnosis, and/or stress reduction techniques.

 

As part of the session protocol, I understand that my online session might be recorded. if the session is being recorded my practitioner retains the copy rights of this material. I understand that my practitioner will not share it with any third party, or use it in public under any circumstances with no written approval from me. 

A copy of the recording will be available for me upon my request. I understand that I do not have the right to upload this material on the internet or share it in public.

 

I also understand that my personal growth and emotional and mental advancement are solely my responsibility, and agree that my practitioner assumes no responsibility for the results of this process.

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This section is only for practitioner training programs:

Participants are not authorized to:-

(i) copy, modify, reproduce, re-publish, sub-licence, sell, upload, broadcast, post, transmit or distribute any of the Course Materials, Presentations, Videos, Handouts without prior written permission signed by Shahira Galal. 

(ii) remove any copyright or other notice on the Course Materials. 

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I certify that I am a competent adult above 18 years old, and I assume all complete responsibility in the final outcome of this session. I am also voluntarily signing this consent form with my full legal name. This waiver and acceptance of risk is effective as of today and it can’t be revoked, altered, modified, annulled or invalidated, without the prior written consent of the practitioner

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Name      ____________________

Signature  ____________________

Date        ____________________

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