Jessica Petter, CH State Registration Code: HP61174361 By law I am required to disclose certain information to my clients. This is for your protection. I graduated from Cascade Hypnosis Center in Bellingham, WA, an advanced program using the 5-PATH technique, founded and taught by Cal Banyan at the Banyan Hypnosis Center in Richardson, Texas. I am a registered and Certified Hypnotherapist and a Certified 5- PATH Hypnotherapist, and I am a member of the National Guild of Hypnotists. In my practice I use hypnosis to help people discover the subconscious reasons for their symptoms, behaviors, or habits. When they are discovered, I use certain tools and techniques to help the client release them and relearn a new positive way of thinking , subconsciously. This is called hypnotherapy. Fees are $150 for per session. Please allow 48 hours' notice to reschedule or cancel any appointment. A $50 fee will apply to repeated late cancellations. The session is confidential, this is your right by law, unless: • You have given written consent stating otherwise. • You confess of a major crime or felony (no one can make you divulge secrets under hypnosis). • You are a minor, and there is physical evidence of abuse. • There is a subpoena for court relating to this session. • Or if there were charges brought against me for unprofessional conduct as described in the Washington State Uniform Disciplinary Code. All sessions at Shift Hypnosis are audio recorded and kept as a part of your confidential record. If you have ever been treated unprofessionally by any hypnotherapist or any health care professional, you may report it to: Dept. of Health P.O. Box 477869 Olympia, WA. 98504-7869. I have read and understand my rights. By typing my name below, I agree to the above terms.