Client Participation Agreement
Referred by: ______________________________Internet______ Other__________
Prior Experience with Hypnosis / Meditation?______________________________________
Motivation for change – 1 very low -10 very high:______Stress Level 1-10________
Do You Have Pain? - 1 – 10 - Where? _________________________________________________________________________
Are you under a Physicians Care for any of the above?____________________
Sleeping quality (excellent, poor, etc)____________________________________________________________
What issue(s) would you most like to change or improve?
Any Fears or Phobias?
Life Goals _________________________________________________________________________
The negative symptoms you’re experiencing have likely been years in the making. Immediate, positive changes do happen but aren’t the norm. Overwhelmingly the clients who have the most profound changes are the clients who are the most committed to change and stick with it.
Like physical training, mental training takes effort and discipline. The more you put into this work, the more benefits you can expect to receive.
We will use the tools of coaching, hypnosis, your inner-guidance and NLP. I will provide self-hypnosis and affirmation tracks for you to use at home to accelerate your change.
I will respect your privacy and your name won’t be connected to any sensitive details of your sessions.
In our work, we may be healing old, emotional wounds. When this happens there can be an emotional detoxification as old energy is released from your body. In other words, things can sometimes feel worse before they feel much, much better.
Please initial here: ___________________
PRICING OPTIONS: (choose one after 1st session)
Hourly: $150/hr. OR Discounted Packages ---
Basic: $810 This basic package includes 6 session hours. It also includes 2 of our self-hypnosis audio mp3 tracks to maximize the effectiveness of your sessions while you listen at home. For some, especially with less complex issues this short-term approach may be sufficient to provide resolution. 10% Discount over the hourly rate.
Committed: $1,530 For most, this will be the best choice: 12 session hours and includes 4 of our self-hypnosis audio mp3 tracks to maximize the effectiveness of your sessions while you listen at home. 15% Discount over the hourly rate.
Fully Committed: $2,880 In-Depth approach includes 24 session hours, 6 of our self-hypnosis audio mp3 tracks to maximize the effectiveness of your sessions while you listen at home. Email and Text Support are included. This is the most effective approach and the most economical. 20% Discount over the hourly rate.
Sessions are usually 1-2 hours in length. Packages: Unused hours expire one year after purchase. Pro-rata refunds based on $150/hr. are not available 45 days after purchase.
Work done with Peter McLaughlin / BlueSky is for self-improvement purposes only and not to be construed as a medical cure for any condition or as a substitute for standard medical or psychological care by licensed medical or psychological personnel.
I am of legal age and I hereby release and discharge Peter McLaughlin and BlueSky Works LLC - DBA BlueSky Hypnosis from any claims, damages or any other actions resulting from my sessions with same.