Welcome – Rowland Hypnosis Centers

Welcome to Rowland Hypnosis Centers!

This short document is designed to help you prepare for your appointment and answer some commonly asked questions. We will also be including billing policies, and information about how I work with clients.

Cancellation Policy

As our policy for cancellation is on both our website and the Scope of Practice that you review below, we won’t cover much of that. We will, however, reiterate that we hold very closely to our cancellation policy. If you need to cancel your appointment, please do so at least 24 hours prior to your appointment. While we understand that things do happen and emergency situations arise, the time is blocked specifically for you and we are unable to fill that spot on short notice.

If you must reschedule, your payment that was made for your appointment can be applied toward the next session provided that the 24 hour policy was adhered to. (These appointment credits are valid for 6 months from the date of your originally scheduled appointment). Unfortunately, failure to inform us of the cancellation within 24 hours will result in that amount not being applied, as the timeframe of the appointment would not have the ability to be filled. If we must cancel your appointment for an emergency, technical issues, or any other reason, you will automatically be provided with a coupon to reschedule the appointment at a convenient time.

Note that there are no refunds as hypnosis is not a results-guaranteed therapy. Every person will respond differently. Payment for services is toward the time of your appointment, not a promised result.

Late Appointments

Please be cognizant of your hypnosis professional’s time. Many times, our appointments are scheduled back to back, so we may not be able to extend your time as it would run in to an appointment with another client. Our policy is to wait 10 minutes from the scheduled time of the start of your session. Failure to log in for your session in that time frame will result in a cancelled appointment. No refunds are given for late arrivals to the appointment or cancelled appointments. For those that are currently on the Financial Assistance Program, this will also constitute a No Call – No Show and would result in termination of your participation in the program and you will be unable to reapply for that service. If you will be late logging in, please let us know so that we can either plan accordingly or, if there is a conflict following your appointment, reschedule you for a more convenient time.

Hypnotherapist Selection

Every effort is made to ensure that your hypnotherapist assigned at the time of scheduling is the provider that you will be seeing. On occasion, (usually in the event of emergency, crisis with a previous client, or illness), if your assigned hypnotherapist is not available, you may be seen by another provider on the staff. All hypnotherapy professionals on staff are required to maintain the same certifications.

Technology

We utilize the software “Google Meet” for all of our sessions. This program is easy for almost any device to operate, and thus makes it a quality product for our services. Google Meet is encrypted and secure, ensuring that only you and your provider will have access. If there is an issue with Google Meet, please let us know prior to the appointment. We also have the option of utilizing another software in rare occasions.

During the appointment, it is helpful to utilize either a laptop with a webcam or a device that can easily be propped up so that we are able to see your face clearly, your torso and your hands if possible. (The recommended hand placement will be on your lap.) You will not be able to hold your device in your hand for this appointment as the somnambulistic state requires extreme relaxation and holding the device would result in either dropping the device or not being able to focus on the intervention itself.

It is also recommended that you use wireless headphones for your sound and microphone, though other headphones will be sufficient. This will allow you to not only hear us and our directions, but also allows us to listen for shifts in breathing, noises, or unconscious murmur while you are in the hypnotic state. If you choose not to use headphones, please understand that there may be feedback as the speakers may be picked up by your microphone.

Hypnosis

As our client, we are embarking on a journey together to help you create the change that you desire in your life. While we are leading with directions and suggestions, the true change is in yourself. At all times, you are in complete control of yourself. Many people have seen hypnosis stage shows or seen hypnosis in the media, leading to a lot of false understandings of the hypnotic states of mind, the unconscious mind, and the control that a hypnotist has over their subject.

In reality, we will serve as your guide, using our knowledge of the unconscious mind and the science of your brain, leading you through exercises that will allow you to have access to those parts of your brain that are hard to reach. We will never “have control” of your mind, nor can we make you do something that you do not want to do. This is a partnership, as mentioned before, and we will be working with you to make these changes happen.

There is no specific “feeling” of hypnosis. Some might feel like they are in a sleep-like phase, and we often refer to hypnosis as “sleep.” While this is a state that is similar to REM sleep, it is actually quite the opposite. Your mind is more focused and awake than it has ever been in the past. This is where the change really occurs. Others might feel like they are floating, and my voice or other sound may become distant or even drift away completely. Rest assured, it is your unconscious mind that I am speaking to and you do not need to consciously hear or listen to what I am saying. Your unconscious is listening intently and will respond whether you remember it or not.

Regardless, hypnosis will become easier with each time that you go into this state. So, while our first appointment might take a while to get you deeply into this state, the second time will be faster. We are training your brain to go to this state.

We will be discussing much of this and more during our first session, so if you have questions, please do not hesitate to ask. The first hour of your session will be for an assessment, information, and questions.

We are looking forward to helping you achieve your goals through the amazing power of your unconscious mind!

Please complete the below intake questionnaire and legal documentation prior to your appointment.

Welcome to Rowland Hypnosis Center’s Family!

Jayson & Kenneth Rowland

Full Legal Name

Email

Acknowledgement of Terms

I, the above named individual, have read the document presented above and agree to all terms therein.

Date of Birth

State of Residence

Gender

Pronouns (optional)

Is there other information you'd like us to know about you personally that might help in your hypnotherapy?

Emergency Contact Name

EC Relationship

EC Phone #

EC Email

Emergency Contact Release

By selecting this box, you agree that Hypnosis412 and its representatives may contact your emergency contact in the event of a medical or mental health emergency. This information will not be used to share information about your treatment or the reason you are being seen by our practice. If this information were to change, you understand that it is your responsibility to update this information with your assigned hypnotherapist.

Are you currently under the care of a medical or mental health professional?

Please list any medical or mental health conditions or concerns. If none, type "none"

Please list all medications, supplements, vitamins, orother substances that you take. If none, type "none".

Have you ever been treated for:

Do you wear:

What is your dominant hand?

In your own words, please describe why you are being seen by our practice:

Select any hypnosis you've tried in the past:

Where you able to achieve a hypnotized state?

Please describe any fears, concerns, or anxieties about your visit or with hypnosis in general. If none, type "none"

Aside from the main reason you are being seen, are there other concerns/issues/goals that you would like to achieve through hypnosis? If yes, please list - if no, type "none"

Acceptance of Terms & Policies

By checking this box, I am giving permission to Rowland Hypnosis Centers and the Certified Hypnotists/Hypnotherapists associated with the practice to use this information to provide me with hypnotherapy assistance. I understand that hypnosis is not an alternative to medical or mental health treatment, but rather is a supplement. I will never be asked or directed to stop or start a medication, be diagnosed with any medical condition or mental health disorder, and I am not being treated by a medical or mental health professional licensed in any state, unless otherwise noted. Hypnosis is used to allow you to access and work within my own unconscious mind.

All hypnosis, even that provided by a qualified professional, is a guided form of self-hypnosis, and I understand that hypnotherapy is to be used to allow myself to have a better grasp of the issue at hand as well as work through achieving goals and freedom from these issues. I understand that, as hypnosis is client-led (meaning I must participate for it to be effective), thus I will be required to participate in order to get results. I understand that it may take multiple sessions before a noted change is observed. I understand that I will be liable for my own actions that I take as a result of these sessions and will not hold Rowland Hypnosis Center, its staff, owners, assignees, or any other related practice liable for any actions that I have taken as a result.

I understand that hypnosis is not "mind control" and that all suggestions will be available for my own unconscious and conscious minds to decide if it is best for me. A hypnotist cannot make me do anything against my will, to harm myself or others. I also understand that hypnotherapy and hypnosis, when not provided by a medical provider that is considered a covered entity is not covered by the Health Insurance Portability and Accessibility Act of 1996, though I have an expectation of confidentiality in the same way that one has an expectation of confidentiality in a religious session with a religious leader. I understand that hypnosis is not covered by most insurance companies and thus Rowland Hypnosis Center will not submit claims to an insurance company. All costs associated with hypnotherapy should be considered "out of pocket" and will not be applied to deductibles.

I understand that all fees paid are for the time booked for the hypnotherapist and are not a guarantee of results. I also understand that there will be no refund on these services and agree that I will not charge back any payments made for these services. A copy of this information, along with my IP address and other ordering identifiers may be provided to my bank as evidence of this policy if one is initiated.

I understand that sessions are recorded for my protection and the protection of my hypnotherapist. These recordings are secure based on current regulatory standards and are not accessible to anyone outside of Rowland Hypnosis Center.

Scope of Practice & Policies

By checking this box, you agree that you have reviewed the Scope of Practice and Policies, linked here.

Digital Signature