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What are your major wellness and self-improvement goals?

You can attach a recent photo for energy reading or other information.

I understand that hypnosis is not a state of sleep; hypnosis is a natural state of mind that can produce extraordinary levels of relaxation. The hypnotherapist utilizes direct and indirect suggestions to facilitate a change in the client’s thoughts, feelings, and behaviors.

I agrees to be the recipient of hypnotherapy sessions, and accepts full responsibility for any and all effects arising from the hypnosis sessions. The client shall hold Alex Akselrod harmless for any physical or mental effects of hypnosis. I agrees that portions of the hypnotherapy sessions may be recorded for our mutual protection. The Hypnotherapist does not share recordings.

No warranty is given, expressed or implied, for satisfactory results from the hypnosis session(s). I understand that the hypnotherapist is not a psychotherapist, and not a medical doctor. At no time will the hypnotherapist attempt to provide medical treatment. The client affirms that hypnotherapy is appropriate for them and does not conflict with existing medical or psychiatric treatment. Always follow the advice of your doctor or other professional medical practitioner.

By signing below, I acknowledge and fully agree with the above information.

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