Client Consent Form

Client Full name:

Date of Birth:

Email:

Contact number:

Address:

Doctors Surgery:

I have read the Code of Care and give consent to receive Solution Focused Hypnotherapy from Bryony Way

I have seen the GDPR policy and am aware of how my data will be processed and stored

I have read and agree to the Terms and Conditions

I am happy to receive occasional information/newsletters from Bryony Way

Date:

This should be the Parent/Legal guardian if the client is under 16.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Δ