Medical History Request Form

The health care professional is asked to provide any relevant medical information, identify any contraindications and determine whether there are any medical. psychological or psychiatric-related factors that may affect the safe and effective use of hypnotherapy.

This process ensures that the patient's welfare remains the primary consideration and supports safe, ethical and collaborative practice between health care professionals and hypnotherapists.

It is not intended to seek a diagnosis, replace medical treatment or transfer responsibility for the client's care.