Waiver Form 

Liability 

I, (The Client) _______________, hereby releases Claudia Nawroth (‘Free of That’) from any liability or claims that could be made against her concerning my mental and/or physical well-being during the work that has been outlined and agreed upon (now and in the future) by filling out this form.  

Scope of Practice 

I understand that ​Claudia Nawroth is not a licensed physician, psychologist, or medical practitioner of any kind and that hypnosis should not be considered a replacement for the advice and/or services, of a psychiatrist, psychologist, psychotherapist, or doctor.  

Participation  

I give ​Claudia Nawroth full permission to hypnotize me and to use Rapid Transformational Therapy knowing that by participating fully in the process and by listening to my personalized recording for 21 days I play an important role in my overall success.  

Guarantee 

I understand that although Rapid Transformational Therapy has an incredibly high success rate, ​Claudia Nawroth ​cannot and does not guarantee results since my own personal success depends on many factors that ​Claudia Nawroth has no ​control over, including my willingness and desire to affect the changes inside of myself.  

Confidentiality 

By signing this form, I consent that ​Claudia Nawroth may release information to a specific individual or agency if it has been determined that a child or elder is at risk of or is currently being abused; if I, as a client, am in imminent danger to myself or others; or if a subpoena of records has been requested.  

I also understand that, at any time, ​Claudia Nawroth ​may discuss aspects of my case with other colleagues keeping my full name and identity completely confidential always unless I have given permission otherwise.