Disclosure
Statement
As required by section 2053.6. (a), of the
California Business and Professions Code
Client
is advised that:
A) Linda Gabriel is not a licensed physician
B) Hypnotherapy is alternative or complementary to the healing arts
services licensed by the State of California
C) The State of California does not license the practice of Hypnotherapy
Hypnotherapist agrees to provide professional services in accordance
with acquired training and experience giving undivided attention during
scheduled consultations to facilitate Client's benefits. Hypnotherapist's
work is Client-centered. Services provided utilize induction of hypnosis,
and methods and principles used to help clients discover their inner
creative abilities to develop positive thinking and feeling and to
transform undesirable habits and behavior patterns. Therapeutic goals
are to achieve freedom from restrictive thought and belief systems,
to assist in solving personal problems, developing motivation and
achieving goals. Client may be taught the use of self-hypnotic techniques
to assist in achieving goals and resolving issues that have been mutually
agreed upon by Client and Hypnotherapist.
Hypnosis is not a state of sleep, but is a natural state of mind that
can produce extraordinary levels of relaxation of mind, body and emotions.
The principles and theories upon which hypnotherapy is based are accessing
and utilizing the power of one's inner resources. Hypnosis can transcend
the critical, analytical level of mind, and facilitate the acceptance
of suggestions, directions and instructions desired by the Client.
The therapeutic use of Hypnosis can also elicit information and insights
from the inner mind. The hypnotherapist utilizes interviews, discussion
and hypnotic methods dealing with underlying issues whenever appropriate,
with the goal to achieve effective and lasting results.
I, Linda Gabriel, have acquired the following education, training,
experience, and qualifications to perform the services offered to
my Clients:
B.A., 1972 and M.F.A., 1976 UCLA
Certified Hypnotherapist by American Council of Hypnotist Examiners,
1992
Licensed Massage Therapist, State of Hawaii (650+ hours) 1993 - present
Certified Clinical Hypnotherapist, Holmes Center for Hypnotherapy,
1999
N.A.T.H. Certified Life Between Life Hypnotherapist, trained by Michael
Newton, Ph.D., 2001
Member National Association of Transpersonal Hypnotherapists
Member and Trainer for the Society for Spiritual Regression (founded
by Michael Newton.)
Craniosacral I & II, Upledger Institute
Cranial Fluid Dynamics I, II, & III with Solihin Thom, D.O.
I, the undersigned Client, acknowledge that I have been advised of
the foregoing information, and that I have been given a copy of this
Disclosure form.
Print Client Name:_______________________________________ Dated:_________________
Client's Signature_______________________________________________________________