CLIENT BILL OF RIGHTS Contact Information: I can be contacted through my office, Mind-Body Dynamics, LLC, at (812) 760-7011. My e-mail is mindbodydynamics@insightbb.com. Credentials: I hold a Bachelor’s degree in biology from Rollins College and a Master’s degree in music theory from the University of South Florida. My degrees have academic accreditation recognized by the United States Department of Education. I have completed the hypnotherapy certification core-curriculum of the National Guild of Hypnotists (NGH), consisting of 100 hours of training. As a Certified Hypnotist and Member of the NGH, I fulfill annual requirements of 15 hours continuing education credits to maintain active certification and keep my training at a high level. I have over twelve years continued experience in hypnotism and have been certified as a licensed hypnotist through the Medical Licensing Board of the State of Indiana (License No. 38000105A). Notice: The practice of hypnotism in the State of Indiana is regulated by the Medical Licensing Board and subject to the Hypnotist Practice Act (IC 25-20.5-1), Health Professions Standards of Practice (IC 25-1-9), and Rules of the Indiana Hypnotist Committee (844 IAC 12). I AM NOT A PHYSICIAN AND MAY NOT PROVIDE A MEDICAL DIAGNOSIS NOR RECOMMEND DISCONTINUANCE OF MEDICALLY PRESCRIBED TREATMENTS. If a client desires a diagnosis or any other type of treatment from a different practitioner, the client has a right to coordinated transfer of services to another practitioner. A client has a right to refuse hypnotism services at any time. A client has a right to be free of physical, verbal, or sexual abuse. A client has a right to know the expected duration of sessions, and may assert any right without retaliation. Confidentiality: I am required by law to maintain the confidentiality of all knowledge and information regarding a client, including, but not limited to, the client’s diagnosis, treatment, and prognosis, and all records relating to the client about which I may learn or otherwise be informed during the course of, or as a result of, the client -practitioner relationship. I may only disclose information when required by law or when authorized by the client those responsible for the client’s care. You have a right to be allowed access to my written record about you. For your and my protection and records, sessions may be recorded. Payment: I accept cash and check as payment at the time of service. I also accept payment via PayPal prior to services. My fee is $110.00 for the initial session and $90 per follow-up session. Discounted sessions are available in packages. Payment schedules are available with packages. Insurance: I suggest you think of my services as something that you will pay for personally. That will both protect your privacy and help you value the work you are doing more. In general, insurance companies do not cover hypnotic services, and I caution you not to expect them to do so. Redress: I am a Certified Member of the National Guild of Hypnotists and practice in accordance with its Code of Ethics and Standards. If you ever have a complaint about my services or behavior that I cannot resolve for you personally, you may contact the National Guild of Hypnotists at P.O. Box 308, Merrimack, New Hampshire, 03054-0308, (603) 429-9438, to seek redress. Other services than my own may be available to you in the community. You may locate such providers in the telephone book.