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ONLINE HYPNOSIS CONSENT FORM

I agree to engage in the process of the following, online via zoom chat or similar with Tara J Clarke: psychotherapy, past life regression hypnotherapy, Holistic Counselling, QHHT, energy healing, soul realignment or akashic records reading, chakra balancing, meridian style tapping, DNA activation, channelling and/or meditation, over the internet. I understand that I will have all choices at all times and can start and end the process at any time, even during my session. I am over age 18, and consent to these services offered by Tara J Clarke. I can confirm that I do not suffer and have never been diagnosed with psychosis or schizophrenia by a medical practitioner, and I am aware that hypnosis is not advisable for individuals with these conditions. also understand that if the session is disconnected at any point, I am to breath calmly and bring myself into my heart space until I can open my eyes and wake back up completely. If I fall asleep I understand that I can reconnect with Tara J Clarke again at a time when we are both available to finish off the session. If I am feeling uneasy after this disconnection I understand that l am to contact Tara via phone on number 0481336666 or +61481336666 from overseas or email immediately for assistance. I understand that after I leave this session that I will receive the recording. I understand that it is important as part of this process to listen to the recording at least once a week for the next few months, take notes and use the recording as part of the process. The services I am agreeing to are held out to the public as non-therapeutic hypnotism, defined as the learning of self-hypnosis to induce positive thinking, create commitment to change and to learn the techniques of self-hypnosis and meditation to produce self-control over physical experiences and emotional awareness. I have been informed as to the limits of hypnosis effectiveness and offered referral to other providers of alternative approaches to problem solving. I agree to continue medication as prescribed by my attending Medical General Practitioner or Physicians, and understand that hypnotherapy, holistic counselling and all those already mentioned is not a substitute for medical care. I understand a hypnotist neither diagnoses nor treat any medical or mental health condition, instead offering tools of self-discovery and awareness to compliment any medical treatment prescribed by a physician. I understand that the methods of hypnosis include relaxation, breath work, creative visualization, positive affirmation, self awareness development and other techniques and may produce physical and emotional responses. I also understand that Tara J Clarke is not a doctor or nutritionist. If I need the advice of a doctor, personal trainer or a nutritionist, I will seek this out separately if needed. I also understand that if i choose to have a past life regression hypnosis with Tara J Clarke, I may go into a past life with my mind, enduring past life memories, and contact my higher self or subconscious for information and I understand that I am completely in control. As a result, I understand that I may remember parts of this session and I may retain memories of those past lives or past experiences. I also agree that if I choose to do any Akashic Records Readings, Soul Clearing or Past Life Regression Hypnosis that the idea is to let go of old blocks and in effect this lifts my vibration. I may also receive information on past lives and I am accepting of this information, negative or positive. I agree that after the session, in lifting the vibration, this may cause a shift in heightened emotions for a period of the first 21 days or so. I am aware of this and understand it is important to move through it naturally. Its part of the process. I agree to inform Tara J Clarke of any adverse feelings or experiences related to this process, at the time of my awareness of them. If any medical symptoms progress or become acute I agree to seek medical attention from a licensed healthcare provider. In the event of a medical emergency or if I feel suicidal, I will call 000 or other emergency help and I give permission for Tara J Clarke to call 000 in case of emergency. If seeking a session with Tara J Clarke in conjunction with my relationship with my spouse/partner I acknowledge that aspects of what may be discussed with Tara J. Clarke in my session may also be discussed and/or disclosed by Tara J. Clarke with my spouse/partner in their session, as I understand that transparency is important in this process, unless I give specific instruction otherwise in writing to Tara J. Clarke. I am of sound mind and completely understand what I have read.

ONCE YOU HAVE READ THIS ONLINE CONSENT FORM, PLEASE SIGN WITH YOUR ONLINE SIGNATURE THAT YOU HAVE READ AND UNDERSTAND THIS FORM

This consent form is for those having a session with Tara J Clarke that is not in person at Palm Cove, Australia and involves hypnosis and any and all of the following tools. Please read all of the following and fill in the consent form below, to confirm that you have read this form and agree to engage in the process. 

ONLINE CONSENT FORM

Please fill out the following form
in order to participate in the session you have purchased.

Tick yes that you have read the above 'Online Consent Form' and that you agree to everything in the above mentioned.
If you feel that you require a person on standby, please give them the phone number of Tara J Clarke here: 0481336666 or +61481336666 if you are outside Australia. Will you require an emergency person, and confirm that you have passed this number onto them?
In the unlikely event that internet is disconnected, you agree that you will come into your centre, focus on your breathe and come back to the present moment. If you are concerned that you may be in a traumatic scene when if this was to happen, you agree to provide an emergency person in the next room that Tara J Clarke can contact. If you tick yes, you must provide the emergency persons

Thanks for submitting!

ONLINE CONSENT FORM

In order to take part in your purchased session, please fill out the form provided. It is important to complete all of the questions and provide all requested details to avoid having to resubmit the form. Tara requires your birth details for assistance with your soul’s Akashic Record. If you choose not to share this information, you will miss out on valuable insights from Tara in the session. Those who have booked an Akashic Record Reading or Clearing or would be open to insight of their Akashic Record, must provide their birth information. If you are having Counselling or Hypnosis, you do not have to provide birth details and this is your choice, just write n/a if you are not comfortable providing these details. 

Tick yes that you have read the above 'Online Consent Form' and that you agree to everything in the above mentioned.
Tick yes, that in the unlikely event that internet is disconnected, you agree that you will come into your centre, focus on your breath and come back to the present moment by grounding yourself back into the Earth with your feet.. Then contact Tara J Clarke when the internet comes back online or you will phone if you feel you need assurance. Are you clear and comfortable with these instructions?
Are you suffering from a medical condition such as epilepsy or heart failure or psychosis or Schizophrenia?
If you feel that you require a person on standby, please give them the phone number of Tara J Clarke here: 0481336666 or +61481336666 if you are outside Australia. Will you require an emergency person, and confirm that you have passed this number onto them?

Thanks for submitting!

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