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Hypnosis Informed Consent Form

Informed Consent & Client Disclosure – Hypnosis Services


Welcome. This document is meant to create clarity, comfort, and transparency so you can decide whether hypnosis feels right for you.


1. Purpose & Legal Framework

Hypnosis services offered by Alan Joseph Prampinare provided in accordance with the **California Health Care Freedom Act (SB 577)** and California Business & Professions Code Sections **2053.5–2053.6**, which allow alternative and complementary wellness services to be offered by non-licensed practitioners within clear boundaries.


These sessions are intended to support personal growth, self-improvement, and insight. They are not a replacement for medical, psychological, or psychiatric care.


2. Scope of Services

Hypnosis sessions are designed to support self-awareness, clarity, and positive change. Session length and number may vary based on individual goals. Experiences and outcomes differ from person to person

No specific results are promised or guaranteed


3. Practitioner Disclosure

Alan Joseph Prampin is not a licensed physician, psychologist, counselor, or healthcare provider. Hypnosis services are offered as complementary wellness support and do not diagnose, treat, or cure medical or mental health conditions.

Clients are encouraged to seek care from a licensed healthcare professional for any medical or mental health concerns.


4. What Hypnosis Is (and Isn’t)

Hypnosis is a guided process that supports focused attention and access to subconscious patterns in a relaxed, aware state.

You remain conscious, aware, and in control at all times

Hypnosis does not override your values or free will

Common experiences include relaxation, imagery, insight, or heightened awareness.


5. Confidentiality

Your privacy is respected, and information shared during sessions is kept confidential to the extent permitted by law.nDisclosure may be required only in limited circumstances, such as risk of imminent harm, abuse, or a lawful court order.


6. Training & Background (Non-Licensed)

Alan Joseph Prampin has completed professional training in hypnosis, meditation, and energy-based practices. These trainings represent continuing education and do not constitute state licensure.


Hypnosis Training & Related Professional Development:

Hypnosis Course Certification – Dr. Karen E. Wells (CTAA & IHTCP accredited)

Hypnosis & the Law of Attraction – Hypnosis Motivation Institute

Everyday Bliss Program – Paul McKenna

Rapid Transformational Hypnosis for Abundance – Marisa Peer

Quantum Jumping Program – Burt Goldman


7. Voluntary Participation

Your participation is entirely voluntary.

You may pause or stop sessions at any time

You are free to ask questions before or during sessions

You remain responsible for your personal choices and well-being


8. Release of Liability

My intention in offering hypnosis is to provide a respectful, supportive, and client-centered experience.


I understand that my participation in hypnosis sessions is voluntary and that I remain responsible for my own health and well-being.

To the fullest extent permitted by law, I agree to release and hold harmless Alan Joseph Prampin, including any associates or representatives, from claims or liabilities that may arise from my voluntary participation in these services, including claims of ordinary negligence. This release does not apply to rights that cannot legally be waived.


9. Client Acknowledgment & Consent

By signing below, I acknowledge that:

I have read and understood this disclosure

My questions have been answered to my satisfaction

I consent to participate in hypnosis services as described above


Typing my full name below serves as my electronic signature, equivalent to a handwritten signature.


Client Name: ________________________________

Date: ________________________________

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