Waiver

Liability:

I hereby release Roslyn Solomon of BodyBalancing LLC from any liability or claims that could be made against her concerning my mental and/or physical well-being during the work that has been outlined and agreed upon, now and in the future by filling out this form.

Scope of Practice:

I understand that Roslyn Solomon of BodyBalancing LLC is not a licensed physician, psychologist, or medical practitioner of any kind and that hypnosis should not be considered a replacement for the advice and/or services, of a psychiatrist, psychologist, psychotherapist, or doctor.

Participation:

I give Roslyn Solomon of BodyBalancing LLC full permission to hypnotize me and to use Rapid Transformational Therapy. I know that participating fully in the process and that listening to the personalized recording for 21 days plays an important role in the overall success that I experience.

Guarantee:

I understand that although Rapid Transformational Therapy (RTT) has an incredibly high success rate, Roslyn Solomon of BodyBalancing LLC cannot and does not guarantee results since my personal success depends on many factors that Roslyn Solomon of BodyBalancing LLC has no control over, including my willingness and desire to affect personal internal changes.

Audio Recording(s):

I give Roslyn Solomon of BodyBalancing LLC permission to make audio recordings that may include my voice. I understand that if a recording (or recordings) are made during or after my session(s) Roslyn Solomon of BodyBalancing LLC retains full copyright over any forms of media that may be produced and distributed to me.

Deepening Process:

During an in-person session, I hereby grant permission to Roslyn Solomon of BodyBalancing LLC to respectfully lift my arm, touch my shoulder, or rock my head gently during my Rapid Transformational session(s) in order to help facilitate the deepening process.

Payment Conditions:

I hereby acknowledge that all payments I make to Roslyn Solomon of BodyBalancing LLC are non-refundable. I will pay in full for each session in advance and it is my responsibility to keep the scheduled appointment/s and/or provide at least 24 hours written notice to change a scheduled appointment.

I further understand and agree that if I miss the scheduled appointment, I will forfeit the money I have paid. I understand and agree that there are no refunds for money paid. However, if an appointment is canceled 24 hours or more prior to scheduled time, the amount will be applied to an appointment at a different date.

Confidentiality:

I consent that Roslyn Solomon of BodyBalancing LLC may release information to a specific individual or agency if it has been determined that I, a child or an elder is at risk of or is currently being abused; if I, as a client, am in imminent danger to myself or others; or if a subpoena of records has been requested.

I also understand that, at any time Roslyn Solomon of BodyBalancing LLC may discuss aspects of my case with other colleagues keeping my full name and identity completely confidential always, unless I have given permission otherwise.

Agreement:

I agree to all the above terms and conditions. By agreeing to receive RTT Hypnotherapy from Roslyn Solomon of BodyBalancing LLC, it is considered the same as if I placed my signature upon this document.