Client Services Request Form PDF

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Wings Hypnosis Client Intake Form

Wings Hypnosis, LLC welcomes ALL people with an open heart and mind regardless of gender orientation, political views, religious affiliations, or belief systems. Hypnosis is a co-operative partnership between the client and the facilitator to create change in both the conscious and subconscious space.

I am a Certified Clinical Hypnotherapist and Lifestyle Coach, not a Licensed Medical Doctor or Mental Health Professional.

Hypnotherapy services performed are non-therapeutic and not intended to take the place of professional counseling, medical, or psychological care and should not be used as a substitute for diagnosis or treatment of any condition. I do not work on pain or diagnosed mental or physical conditions without the referral from a licensed practitioner of the healing arts per Florida Statute Section 485. If you are under the care of a medical professional for any condition for which you are seeking hypnosis support, please obtain a signed, written referral from your provider prior to contacting me and moving forward with sessions.

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727-835-6566 • 3632 Land O Lakes Suite 105-8, Land O Lakes, FL 33558 • wingshypnosis@gmail.com