1. Practitioner & Business Information
Business: Institute of Behavioral Profiling & Hypnosis (IBPH). Mailing/office location: Puyallup, Washington. Telephone: (253) 617-9707. Email: Info@IBPH.org.
Your practitioner's individual name, business name, office address, telephone number, and Washington State hypnotherapist credential number are provided to you in writing on the signature page and in your confirmation email before your first session.
Required consumer notice: Counselors and hypnotherapists practicing for a fee must be credentialed with the Washington State Department of Health for the protection of the public health and safety. Credentialing of an individual does not include a recognition of any practice standards, nor necessarily imply the effectiveness of any treatment.
2. Education, Experience & Methods
Background: Each IBPH practitioner has completed formal hypnotherapy training and supervised practice, and is trained in ethics, informed consent, safe practice, and scope of practice. Your practitioner's specific education, training, and years of experience are listed on their public IBPH profile and are provided to you on request.
Therapeutic orientation: In plain language, hypnotherapy at IBPH uses guided relaxation, focused attention, and suggestion to help you work with habits, stress responses, and self-limiting patterns. Methods your practitioner may use include parts negotiation and parts therapy, reframing, values alignment, the arrow technique, timeline therapy, anchoring, future pacing, modeling, behavioral profiling (face reading and Enneagram), and — where the practitioner is trained in it — regression work such as QHHT. You are always awake, aware, and in control, and you may stop at any time.
Course of treatment: Many concerns are addressed in three to six sessions; some are shorter and some take longer. Your first session includes an additional 30 minutes of intake at no charge. Sessions typically run 45–90 minutes. Your practitioner will discuss an expected number of sessions with you after intake; this is an estimate, not a promise of a result.
3. Financial Requirements & Billing Policies
Session cost: $200 per session, flat, regardless of whether the session runs 45 or 90 minutes. This rate is the same for every IBPH practitioner. All fees are plus Washington State sales tax where applicable.
Packages: 3 sessions $525, 4 sessions $680, 6 sessions $960, 12 sessions $1,560. Packages are paid in advance and are limited to no more than two sessions per week.
Payment terms: Single sessions are paid before or at the time of the session. Packages are paid in advance. Accepted methods are provided in your confirmation message. IBPH does not bill insurance.
Cancellation: Please give at least 24 hours' notice to reschedule. Sessions cancelled with less than 24 hours' notice, or missed without notice, may be charged in full or deducted from a package.
Refunds: Completed sessions are non-refundable. Unused, unexpired sessions in a prepaid package may be refunded at the single-session rate of $200 per session already used, subtracted from the amount paid. Refund requests are made in writing to Info@IBPH.org.
4. Mandatory Legal Statements
Scope of practice: Your practitioner is not credentialed to diagnose or treat mental disorders and does not provide traditional psychotherapy, medical care, or psychological care. Hypnotherapy is not a substitute for care from a licensed physician, psychologist, or mental health professional, and no medication should be started, stopped, or changed based on anything said in a session.
No guarantee of effectiveness: Registration or credentialing by the State of Washington does not include a recognition of any practice standards, nor does it imply or guarantee the effectiveness of any treatment. No specific result is promised.
Client rights: You have the right to refuse any treatment or technique, to stop a session at any time, to change practitioners, to seek a second opinion, and to choose a different treatment modality or provider at any time, for any reason.
Accountability: To report a concern about unprofessional conduct, contact the Washington State Department of Health, Health Systems Quality Assurance, Complaint Intake, P.O. Box 47857, Olympia, WA 98504-7857, phone (360) 236-4700.
5. Confidentiality & Limits
Privacy: Session notes, intake forms, and this signed acknowledgment are stored in restricted, access-controlled digital records available only to your practitioner and authorized IBPH administrators. Records are retained as required by law. Sessions are held over Zoom and are not recorded unless you give separate written consent.
Limits to confidentiality: Information may be disclosed without your consent where the law requires it — including suspected abuse or neglect of a child, a vulnerable adult, or an elder; a credible threat of serious harm to yourself or an identifiable other person; and a valid court order or subpoena.
6. Signed Acknowledgment
By typing your full legal name below and submitting this form, you acknowledge that you have read and understood this disclosure statement before your first session, and you consent to receive hypnotherapy services from IBPH. Your practitioner countersigns this document, and IBPH retains a copy of the signed acknowledgment in your permanent client record. A copy is available to you on request at Info@IBPH.org.