Acknowledgment of Non-Medical Services I acknowledge that A Little Hypnosis, LLC, including its owners, staff, and affiliated entities, are not medical professionals. I understand that they do not diagnose, treat, or prescribe any treatment for medical or mental health conditions.

Consideration of Alternatives I confirm that I have thoroughly considered all available options, including medical interventions. I recognize that this is a significant life decision and have taken sufficient time to contemplate the implications of this intervention. I choose to proceed with this course of action of my own free will.

Right to Terminate and Potential Irreversibility I understand that I have the right to terminate this request at any time. However, I acknowledge that the results of this intervention may be irreversible or may require an extensive period of time to reverse. I accept that if reversal is not possible, I may remain permanently incontinent following this intervention.

Understanding of Non-Substitution for Medical Care I understand that the services provided by A Little Hypnosis are not a substitute for clinical mental health care or medical care. These services are not intended to diagnose, treat, or cure any mental health or medical conditions. I acknowledge that no member of the A Little Hypnosis team is a licensed medical or mental health practitioner.

Personal Responsibility I acknowledge and agree that I am fully responsible for my actions and overall well-being. I understand that any comments or suggestions made by the hypnosis professional are intended solely to assist me in achieving my defined goals and enhancing my mental well-being.

Informed Consent I hereby give informed consent to A Little Hypnosis, LLC, to assist me in achieving my goals. I understand that if the hypnosis professional believes it is in my best interest, they may recommend that I seek further medical review. If I choose not to follow this recommendation, I understand that hypnosis services may be discontinued immediately.

Release of Liability I hereby release, waive, acquit, and forever discharge A Little Hypnosis, LLC, my hypnotist, and any associated agents, successors, assigns, personal representatives, executors, heirs, and employees from any and all claims, suits, actions, demands, or rights to compensation for damages that I may have arising out of my own actions or omissions, or the actions or omissions of my hypnotist, as a result of any advice given or otherwise resulting from the hypnotist-client relationship as contemplated by this agreement. I declare that no promises, inducements, or agreements not expressed in this document have been made.

Termination of Services I understand that I have the right to terminate the hypnotist-client relationship at any time during the intervention. I also understand that A Little Hypnosis, LLC, and its staff reserve the right to terminate this relationship or discontinue work toward any goal that they deem uncomfortable or inappropriate at any time.