Financial Assistance – A Little Hypnosis LLC

With most insurance companies not covering services for hypnosis or hypnotherapy, financial hardship can be a barrier to receiving the services that you need. Having this in mind, we are announcing our Financial Assistance Program. This program will allow limited spaces, providing hypnosis services at a discounted rate, and making the services more accessible. The program has the following notes. Please review them and ensure you agree before submitting the application.

Once received, your application will be reviewed and, if approved, you will receive an email verifying your enrollment. With this program, your discounted rate will be provided in that initial email and billing will be informed. After approval and enrollment in the program, you will make your appointments via a personalized scheduling link that will be programmed with your discounted rate.

1. Please note that the services you receive will be identical to all clients. The discounted rate does not have an effect on your actual services.

2. Services will not be provided without payment. While this program is designed to help those who are unable to afford services, it is not a free program. Limited spaces are in place and, if approved, you will be required to pay the agreed upon amount given at enrollment to continue the program.

3. Clients on this program MUST attend scheduled appointments as required in the cancellation policy. Clients must provide a 24 hour notice of any cancellation. Failure to do so will result in termination of the enrollment in the Financial Assistance Program.

4. All applicants must have a genuine need for this program.

5. Hypnosis appointments are scheduled based on the agreed upon plan made with your hypnosis professional during your initial assessment. Therefore, appointments should not have extended gaps unless stated as such on the plan. In most cases, the hypnosis professional will recommend weekly appointments to assist with the changes you are seeking help with.

6. Should you apply and be approved, please note that this program will end once recommended scheduled appointments have been completed. If, in the future, you need to come back and see us, a new application must be completed and approved, provided financial assistance is still needed.

7. If your hypnosis professional sees the need to extend your scheduled appointments while on this program, your enrollment will continue provided that the need is still there for assistance AND the extended appointments are sequential to the previous plan.

8. As with all hypnosis services, this is a partnership to help you achieve your goals. It is expected that the recommendations of the hypnosis professional are followed as directed, and you, as our client, actively work toward the goals. There are no guarantees for outcomes as hypnotic work is dependent on not only the hypnosis professional, but also the client’s willingness to change and their ability to accept that change.

9. There will be absolutely no refunds of any services booked. Payment is toward the time of the hypnosis professional, and not a specified outcome. Cancellations that have a 24 hour notice will be able to reschedule the appointment and have the fee paid transferred to the new appointment. Failure to provide notice of cancellation prior to 24 hours before the appointment will result in the booking fee not being transferred to new appointments.

10. If, during your enrollment in this program, your financial situations changes and you no longer need assistance, you are expected to be honest with your hypnosis professional and let them know. As mentioned, this program is limited to a small number of spots. Continued use of the program when you do not need it any longer has a negative impact on those that are waiting to use this spot.

11. Please note the minimum payment amount under this program is $35/session.

12. Once approved, your appointment must be scheduled within 15 days of said approval. The appointment does not need to take place within that 15 days, but must be scheduled and paid. If appointments are not scheduled in this time frame, you will be removed from the program and will need to reapply. Approval is subject to availability of open spaces for the program. Removal from the program will result in being placed on a waiting list if all other spots are taken up.

13. The Financial Hardship Program cannot be utilized for your initial assessment. At times, we are able to make an exception based on significant financial hardship. Choosing “Yes” on the question related to Initial Assessment financial help will trigger a full review by administration and, if approved, a session link will be provided in the acceptance email.

14. Please note, at this time, Financial Assistance is only available to residents of the United States of America. If you are outside of the United States, please reach out to info@alittlehypnosis.com to request a case-by-case review.

15. All no-call/no-shows will result in immediate removal from the program without notice and the client will not be eligible for future admission to the Financial Assistance Program.

Name

Street Address

City

State

Zipcode

Telephone

Monthly Net Income After Tax

Monthly Expenses

If accepted, what amount can you afford for each session? (Minimum $35)

Please provide the main reason that you'd like to receive hypnotherapy:

Please provide more information about your financial assistance, if possible. This will help us in making our final decision.

While the Intial Assessment is not included in this program, on rare occasions we are able to approve a discounted rate for this appointment as well. Would you like to have your situation evaluated for decreased initial assessment fees?

Yes No

I have reviewed the information on this page regarding the Financial Assistance Program. I agree to follow all requirements as outlined above. I understand that this is an application for assistance and not a legally binding contract for services and no guarantee of approval is promised.

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