Form Downloads
- Acknowledgement of Services and Fees (DOC 24 KB)
- Application – Personal Data Record and Release (DOC 26 KB)
- Consent to Release Information (DOC 22 KB)
- Disclosure of Services (California) (DOC 84 KB, Rev: 2022-08-12)
- Life History Questionnaire (PDF 17 KB)
- Medical Referral Form – Notice of Hypnotherapy Services (California) (DOC 42 KB)
- Medical Referral Form – Notice of Hypnotherapy Services (Outside California) (DOC 42 KB)
- Pro-Bono Acknowledgement of Services (DOC 34 KB)
- Request for Therapist Referral (PDF 12 KB)
- Request for Therapist Referral – Reply (PDF 12 KB)