If Client is under 18 years of age, parental or legal guardian signature below denotes permission for client to enter into this work.
Each session is up to 90 minutes
If signed by legal guardian on behalf of a client, please type your name here and specify your relation to the client.

 SERVICES: You will receive individual session(s) you have selected for up to 90 minutes each in duration. In addition, you may receive additional products and/or services as deemed appropriate by your hypnotherapist. Sessions may include the use of hypnosis, Neurolinguistic Programming, coaching, Emotional Freedom Technique or other modalities.

FEES/TERMS OF SERVICE: Your investment is a fee for the services selected above in the SERVICES section. Payment is subject to CANCELLATION AND REFUND policies herein, and you are committing to hypnosis sessions you have selected in the form above.

CANCELLATION POLICY: Cancellations must be made at least 24 hours before your appointment to avoid a no-show or late cancellation fee. If you arrive 15 minutes late or more, we may not be able to accommodate your appointment and you will be charged a late appointment fee of $75. More than 15 minutes late, no call/no show or last minute cancellation will result in forfeiture of that session. This is out of courtesy to the time of all parties involved.

WARRANTY: Jody Lee Kimmell Hypnotherapy Services warrants that in carrying out the Services it has and will exercise all reasonable skill and care expected of an experienced professional, in such work.

SERVICE PERIOD: The Service Period of the Agreement is the period of time during which the Services (sessions) are delivered to the Client. Client signature below indicates acceptance of the terms of this agreement and the accuracy of the information provided regarding date of birth, etc. as well as acknowledgement of  receipt of a copy of this full agreement. (2 pages in length).

LIMITATION OF LIABILITY: Fees are determined on the basis of the limits of liability set out in the Terms and Conditions. The Client may, by written notice to Jody Lee Kimmell Hypnotherapy Services, request Jody Lee Kimmell Hypnotherapy Services to propose a higher limit of liability subject to an increase in Fees. This Clause sets out the entire liability of and the exclusion thereof by Jody Lee Kimmell Hypnotherapy Services, under and/or in connection with this Client Agreement. By signing this Agreement, Client agrees to limit Jody Lee Kimmell Hypnotherapy Services liability and such liability shall not exceed the Fees set out under Fees/Terms in this Client Agreement.

MATERIAL FOR PERSONAL USE ONLY: Jody Lee Kimmell Hypnotherapy Services audios, videos, website materials, written materials, handouts, and processes are the intellectual property of Jody Kimmell and Jody Lee Kimmell Hypnotherapy Services, and are for the client’s personal use only. They cannot be duplicated, re-transmitted or used by or with anyone else without express permission. Thank you for adhering to this stipulation.

MEDIATION OF DISPUTES: In the event a dispute shall arise between the parties to this [contract, lease, etc.] the parties agree to participate in at least four hours of mediation in accordance with the mediation procedures of the mediator chosen by Jody Lee Kimmell Hypnotherapy Services. The parties agree to share equally the cost of the mediation.

CONFIDENTIALITY: Matters regarding your sessions will be kept confidential except in the following circumstances: You grant me specific permission to release information to a specific individual or agency; child abuse; you are in imminent danger to self or others; or in the case of subpoena of records. Any information shared is kept confidential. From time to time, we may also case-consult with other colleagues, but in this circumstance, clients are not identified by name.

ANTI DEFAMATION: Clients agree not to attack or criticize Jody Lee Kimmell Hypnotherapy Services and/or its employees, associates or partners publicly (on public forums, blogs, social networks, etc.) at any time during or subsequent to the service period. Similarly, Client agrees not to seek SEO advice on SEO forums, blogs, community groups or any social media in a way which brings a bad name or negative publicity to Jody Lee Kimmell Hypnotherapy Services or any of its employees, associates or partners. In case of breach of this clause, in recognition of the value of the reputation of the business and the cost of mitigating such damage, Client agrees to pay $10,000 to Jody Lee Kimmell Hypnotherapy Services in damages.

REFUNDS: In the event of a refund, used sessions will be prorated against your package at the current single session rate. Per the above Cancellation Policy, a session cancelled with less than 24 hours notice constitutes a used session and is not eligible to be refunded for cash value.

ENTIRE AGREEMENT:  This Agreement constitutes the entire agreement between the parties with respect to its subject matter and constitutes and supersedes all prior agreements, representations and understandings of the parties, written or oral.

INFORMED CONSENT: I understand that hypnosis as practiced by my hypnotherapist is not a medical treatment, but a process whereby an individual is taught to use his or her own abilities for his or her own benefit. Hypnosis, hypnotherapy, NLP, EFT, guided imagery and self-hypnotic techniques are not in any way meant to substitute for standard medical, psychological, or psychiatric treatment. I understand that my hypnotherapist does not diagnose or treat medical issues. The techniques utilized in performing these Services are an adjunctive/complementary approach for self-healing, self-help, and vocational and avocational self-improvement. With this understanding, I hereby grant permission to my hypnotherapist to hypnotize me. Potential clients under the age of 18 must provide written consent by a parent or legal guardian to use any services provided by Jody Lee Kimmell Hypnotherapy Services.


All new clients must begin with a free 30-minute consultation.

Call 651-890-2728 now
to schedule your first appointment.