Terms & Conditions *
I or my representative(s) agree to fully release and hold harmless Dhaval Modha/DMhypnosis from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s). Under no circumstances including but not limited to negligence shall Dhaval Modha or any of his staff members be liable for any special or consequential damages in any way whatsoever now or in the future that results from the use of or the inability to use hypnosis or any other therapies used or coaching. The information, techniques, hypnosis, methods or recommendations by Dhaval Modha is not intended to substitute for the diagnosis and care of a qualified physician nor to encourage the treatment of illness by persons not recognizably qualified. If you use hypnosis and are under the medical care for any condition do not make any adjustments to any prescribed medication without the approval of your doctor. If any doubt you should always seek your physician's advice. Epileptics should not enter hypnosis or anyone diagnosed as having the psychotic illness. 

I am approving these terms and conditions I understand and verify that all information is complete and accurate to the best of my knowledge. I also understand that the hypnotic methods used by Dhaval Modha are not a substitute for medical or psychiatric treatment. I understand these methods to be a conditioning process, whereby an individual is taught to use their own abilities for their benefit and wellbeing. With this understanding, I hereby grant Dhaval Modha permission to hypnotize me. I further grant permission for the sessions to be recorded/taped as needed. I know my progress is dependent upon my efforts and that there are no guarantees as to the result or progress to be made. I understand that the success of the treatment will be in direct proportion to my commitment to the end result. The fees are billed upfront via Paypal, Stripe or cash and the payment or first installment of the payment plan needs to be received in order to begin our sessions.  All appointments not cancelled or rescheduled with 24 hours notice will be charged in full. If client has purchased a package and find oneself unable to use the sessions for any reason, client may put the remaining sessions on a 3-month hold. Session credits will not be carried out further than 3-months. The fees are nonrefundable. Dhaval Modha only works with the clients who are committed. There will be no refunds as a matter of course. Dhaval Modha retains the right, at its sole discretion, to refund payment in the event of extenuating circumstances where it may deem such action appropriate. Parties may terminate this contract at any time. It is the intent of the Parties that, notwithstanding any termination, the paragraphs concerning Confidentiality, Liability, Disputes and Miscellaneous will survive this Agreement.

Client commitment 
1. I give my full consent to receiving hypnosis sessions by Dhaval Modha now and in any future sessions. 
2. I understand that results vary and that the practitioner may not guarantee results. 
3. I understand that Hypnosis/Coaching is not a replacement for medical treatment, psychological or psychiatric services or counseling. I also understand that the Consulting Hypnotist does not treat, prescribe for, or diagnose any condition. If Client believes that the sessions are not working as desired, Client agrees to first communicate this to Dhaval Modha. 
4. I give the practitioner permission and consent to do so to help me establish a beneficial state of hypnosis. 
5. I have been advised that I am free to terminate any or all sessions at any time. I have agreed to participate in each session to the best of my ability. 
6. I have accurately provided background information as requested. 
7. I understand that confidentially and anonymity regarding my sessions will be honored between Dhaval Modha and me.
8. I understand that, depending on the state of my physical/mental/emotional health, further medical/psychiatric treatment may be needed and will be suggested to me and documented by Dhaval Modha if he determines my situation to be outside the scope of coaching or hypnosis. 

I am confirming that all information is true to the best of my knowledge and I completely understand and agree to the terms and conditions. By submitting this form and signing it with my initials, I agree to all the terms listed above.