Beautiful Mind

Medical Waiver

Please fill out the requested information on the history form completely. The signor should regularly consult a health professional in matters relating to his or her health, and with respect to any symptoms that may require diagnosis, medical or psychological assessment. 

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Beautiful Mind Hypnosis & Hypnotherapy

By signing this medical waiver, you are agreeing to assume full responsibility for any risk, injury, or damage knowing or unknowing which might incur as a result of participating with the owners and practitioners of Beautiful Mind Hypnosis and Hypnotherapy. The signor knowingly and voluntarily waives all rights to any or all claims that the signor may have now or in the future against Beautiful Mind Hypnosis and Hypnotherapy and the practitioners and owners. I am agreeing to release the practitioners and owners from all liability and will not hold the practitioner and owners responsible in any way. 

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