FOR YOUR FIRST VISIT


 
 Atlanta West Hypnotheraphy Clinic wants to make your first visit with us go as smooth as possible.  In order to reduce your time spent at the Clinic establishing yourself as a new client, we provide our new client video and paperwork here. 
 
We provide two versions of the video and the paperwork below - one for adults and one for clients who are 17 years of age and younger. Please select the appropriate version and follow the instructions provided.
ADULT CLIENTS
 
Before your visit, watch Dr. Laura LaRain explain HOW and WHY Hypnotherapy works in this 28 min video.
CLICK the picture to start the video
Adult Client Forms

The New Client Forms package includes the following documents:
  1. Instruction Sheet (duplicate of the instructions below)
  2. Client Personal Data Record - complete this form.   
  3. Health Appraisal Indicator - Hypoglycemia - Check each item on the list that applies to you. For the last item #55, please mark 'Yes" or 'No'               
  4. Acknowledgement of Services and Fees - Read and complete the bottom section                              
  5. Confidentiality Acknowledgement - Read and sign.

                                                                                                                                                                                                                                 

Please provide all of the completed forms to the receptionist upon your arrival to the clinic.
Document
( AWHC_New_Client_Forms2017_1_.pdf
MINOR/CHILD CLIENTS
 
Before your visit, watch Dr. Laura LaRain explain HOW and WHY Hypnotherapy works in this 22 min video.
CLICK the picture to start the video
Minor/Child Client Forms

The New Client Forms package includes the following documents:
  1. Instruction Sheet (duplicate of the instructions below)
  2. Minor Client Personal Data Record - complete this form down to the bold line at the bottom.
  3. Health Appraisal Indicator - Hypoglycemia - Check each item on the list that applies to your minor/child. For the last item #55, please mark 'Yes" or 'No'
  4. Acknowledgement of Services and Fees - Read and complete the bottom section
  5. Confidentiality Acknowledgement - Read and sign.
  6. Minor Legal Guardian Treatment Consent - complete and sign

 

Please provide all of the completed forms to the receptionist upon your arrival to the clinic.
Document
AWHC_New_Child_Client_Form.pdf