Agreement for provision of Hypnotherapy Services (Individuals)

The undersigned client acknowledges that he or she has been informed of the following information:

Clinical Hypnotherapist - Katie Samye BA MSc Dip.Hyp GHR (Reg.) GHSC (Accred.)

I am a qualified clinical hypnotherapist and registered accredited member of The General Hypnotherapy Register and the General Hypnotherapy Standards Council: https://general- hypnotherapy-register.com and a registered practitioner with the Complementary and Natural Healthcare Council: https://www.cnhc.org.uk/ I uphold the GHSC and CNHC’s values and ethical framework for good practice and am accountable to them. I hold appropriate professional indemnity insurance.


I retain anonymised notes relating to hypnotherapy sessions, to remind me of session content, consider future input and gauge therapeutic progress. These notes also support supervision requirements. I destroy any notes 7 years after the hypnotherapy work has ended. To read my privacy policy, please visit: https://www.katiesamyehypnotherapy.com/privacy


If you are not happy with any aspect of your experience of working with me, you should bring this to my attention so that we may both understand what has gone wrong and why. If you cannot resolve matters in this way, you have a right to refer the matter to the General Hypnotherapy Standards Council: https://general-hypnotherapy-register.com


Unless I have your express written authority to disclose information, and apart from exceptional matters as detailed below, you can be assured of complete confidentiality concerning your identity and content of hypnotherapy sessions.

Regulatory Disclosure Requirements

It is a GHSC requirement that I regularly consult with a senior colleague to share detail of my work; this process ensures that I remain compliant with expected standards and that you receive appropriate support. This is an anonymised process of supervision, so your confidentiality is assured.

Mandatory Disclosure Requirements

I have a legal obligation to report, to the appropriate authorities, any disclosures or suspicions relating to terrorism, laundering of drug money, FGM and other serious crimes. In response to an appropriate court order, I could also be obliged to release my notes to the appropriate authorities and/or be ordered to attend court in a witness capacity etc.

Discretionary Disclosures (in Public Interest)

Enshrined within the GHSC’s values and ethics is an obligation and duty of care to respect the human rights of all and the wellbeing of my clients. With this in mind, I uphold my right to disclose certain matters, particularly if a client lacks capacity, is seriously distressed or disturbed to the degree that I consider them to be at serious risk of harm to themselves or to others or if consider vulnerable adults or children to be at risk. In the event that I consider it necessary to make a discretionary disclosure, I would aim do so in a fully transparent way and with client agreement, where reasonably possible.

What is Hypnotherapy & How I Work

Katie Samye (hereafter referred to as “hypnotherapist”) agrees to provide professional services in accordance with acquired training and experience giving undivided attention during scheduled consultations to facilitate the client’s benefits. The hypnotherapist’s work is client-centered. Services provided utilise induction of hypnosis, and methods and principles used to help clients discover their inner creative abilities to develop positive thinking and feelings and to transform undesirable habits and behaviour patterns. Therapeutic goals are to achieve freedom from restrictive thought and belief systems, to assist in solving personal problems, developing motivation and achieving goals. A client may be taught the use of self-hypnotic techniques to assist in achieving goals and resolving issues that have been mutually agreed upon by client and hypnotherapist. Hypnosis is not a state of sleep, but is a natural state of mind that can produce extraordinary levels of relaxation of mind, body and emotions. The principles and theories upon which hypnotherapy is based are accessing and utilising the power of one’s inner resources.

Hypnosis can transcend the critical, analytical level of mind, and facilitate the acceptance of suggestions, directions and instructions desired by the client. The therapeutic use of hypnosis can also elicit information and insights from the inner mind. The hypnotherapist utilises interviews, discussion and hypnotic methods dealing with underlying issues whenever appropriate, with the goal to achieve effective and lasting results.

Services to be provided do not include the practice of medicine, as a hypnotherapist is not a licensed physician. A hypnotherapist’s services are non-diagnostic, and are defined as complementary and natural healthcare, as defined by the Complementary and Natural Healthcare Council of the UK, of which I am a registered practitioner: https://www.cnhc.org.uk/

The primary purpose of bodies such as the The General Hypnotherapy Register, the General Hypnotherapy Standards Council and the Complementary and Natural Healthcare Council is to protect public health and safety and build confidence in hypnotherapy and complementary healthcare therapies.

I understand that these sessions are not psychotherapy but are a therapeutic alternative aimed at creating positive changes in my life. I agree to inform my hypnotherapist of all physical or mental conditions that might affect her work with me. I understand that I am a full partner in creating changes and am willing to participate during my sessions and to complete any home assignments.

The first session will be approximately 90 minutes, future sessions 60 minutes. Please allow 30 minutes extra time in case sessions run on.

Appointments are either on zoom or in person.

All sessions are to be booked on Calendly via a booking link emailed to you.

I require a 24-hour cancellation notice. Missed or late cancelled sessions are charged at full fee.

Appointments can be re-arranged via your Calendly booking email confirmation.

All appointments must be paid for when booking the sessions, either by bank transfer or by a Stripe payment link.

Four-week and eight-week programs must be paid for in full, in advance of the first session.

For programs longer than eight weeks, payment plans may be agreed upon and commenced in advance of the first session.

Text and email confirmations and reminders will be sent to you on booking and before your sessions.

How to make the most of hypnotherapy

The view I take of the therapeutic process is that it is an investment in your life, not just a cost. I often say to clients that I cannot do the work for them, but can work to best effect by taking the journey beside them, as their facilitator. This process is most likely to be effective if you can quickly establish a trusted working relationship with me; one where you feel able to:-

  • Be open and honest.
  • Say how you are really feeling.
  • Reflect on and talk about your experiences.

My signature attests that I have read and understand this Agreement for provision of Hypnotherapy Services (Individuals) and understand that on submitting the form, I will receive an emailed copy of it. My signature also attests that I agree to give no less than a 24-hour cancellation notice and that I will be charged full session fee for any late cancellations or missed appointments.