The Co-Creative Process

In order to be more successful in reaching my goals, I (the client) agree to:

• Be an active participant in my hypnotherapy and other modalities experience and see myself as a partner in the transformative nature of this process.

• Recognize that my thoughts, feelings, images and actions have a direct effect on the quality of my life.

• Acknowledge that my well being depends directly on how well I care for myself physically, emotionally, intellectually and spiritually.

• Accept that blaming others or myself is totally futile.

• Take responsibility for my experience of life, because I create my life experience to the best of my ability in the moment with what I know right now.

• I agree to be on time for my sessions and allow at least 24 hours of advanced notice should I need to cancel or reschedule a session (if I cancel or reschedule within 24 hours of a session I agree to be charged in full for that session with a credit card on file or an applicable prepaid plan or pass).

Limits on Confidentiality of Information

Clients have a right to expect that information revealed in sessions not be disclosed without extraordinary justification. The conditions that justify the release of information and by law must be reported to the appropriate agencies are the following:

• Knowledge of child abuse or neglect.

• Knowledge of senior citizen abuse or neglect.

• A client poses a serious risk of suicide and is an imminent danger to self.

• A client poses a threat of imminent danger to another person.

• A judge, by issuance of a court order, may obtain information.

• Report to law enforcement authorities knowledge of a felony that has been or is being committed.

• In other situations, signed authorization for release of information is required.

Agreement

Hypnotherapy, Time Line Therapy TM (regression therapy) Core Wound Healing, Grief Recovery, life coaching and Neurolinguistic Programming (NLP), like the practice of medicine, are not absolute sciences. I personally know of no case on record where an individual has been harmed by the use of these methods. I do know of thousands of cases where people of all walks of life have benefited greatly from the use of these methods. As a general practice, it is necessary for everyone taking part in private sessions, classes, workshops and seminars with Catherine Napoli to sign this Release of Liability Agreement.

I am of legal age and, in consideration of my acceptance as a participant in this private hypnotherapy or coaching session, seminar, workshop, class or other training, I for myself, my heirs, my executors, administrators and assignees, do hereby release and discharge Catherine Napoli and any of her employees, her employer or other participants in any of the activities from all claims of damages arising from or growing out of my participation in said activities. I agree that any claim of damages or disputes arising from my participation in Hypnotherapy, Time Line Therapy TM (regression therapy) Core Wound Healing, Grief Recovery, life coaching and Neurolinguistic Programming (NLP), should it arise, shall be settled by binding arbitration before an extra-judicial arbitration and mediation service selected by the parties. I further understand that recordings may be made at any of these events and that Catherine Napoli and her organization retain the copyright to all of these recordings.

I understand that all services provided by Catherine Napoli are for educational and self-improvement purposes only. I further understand that Catherine Napoli does not practice psychotherapy or medicine and are therefore not offered as a substitute for counseling, psychotherapy, psychiatric or medical treatment. Consultation and/or referral from a physician or mental health professional may be required before hypnotherapy services are provided.

It is your right to refuse any aspect of Catherine Napoli’s services and to seek the service of another provider at any time. Catherine Napoli’s standard fee is $175 per session. Sessions are typically from 30 to 90 minutes in length. Refunds are not provided for past services or any recordings.