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Agreement & Consent

Client birthday


Hypnosis Agreement

This Agreement made between you [The Client] and Krystal Rose [RTT Hypnotherapist Therapist and Coach] outlines the nature of the therapeutic relationship. It include roles, expectations, and working arrangements for the duration of the coaching sessions. 

The Use of Hypnotherapy

Krystal's hypnotherapy sessions can combined hypnosis, talk therapy, and NLP to explore the clients subconscious mind, gain insights, and change habits or mindset. The purpose of hypnotherapy to develop and implement strategies to help the client reach personally identified goals. Throughout the therapeutic relationship, Krystal may engage the Client in very direct and personal conversations, and induce hypnosis to allow access to the Client’s subconscious mind. 

During a hypnotherapy session, Krystal may:

• Lead the Client into a deeply relaxed state – most people feel refreshed and relaxed. 

• Review memories of events that were the root cause of the issue the Client is experiencing. 

• Use methods to help the Client towards desired outcome – for example, make suggestions to the Client's subconscious that they decide upon, such as suggesting that they do not want to carry out a particular habit. 

• Gradually bring the Client out of the trance-like state. (After which, most people feel refreshed and relaxed.) 


During hypnotherapy, the Client are fully in control when under hypnosis and do not have to take on the suggestions if the Client does not want to. 

If necessary, the Client can bring yourself out of the hypnotic state. Hypnosis does not work if the Client does not want to be hypnotized. 

During hypnotherapy, there may be reason to review some unpleasant memories or experience some uncomfortable emotions. It is acknowledged that making personal changes in behavior, thinking and emotions through hypnotherapy sometimes requires learning by trial and error, and so some confusion or setbacks in the process may occur. The Client acknowledges and agrees to accept these potential risks.

Please note: The Client should not stop or alter any medication or treatment they are currently receiving without the prior consent of their doctor or mental health advisor.

The Therapeutic Relationship of Coaching and Hypnotherapy

The purpose of the therapeutic relationship is to empower the Client and support them to achieve their desired outcome and goals.

Client’s Responsibilities 

Krystal will encourage the Client to take responsibility for setting their own agenda and ask that the Client: 

• Focus on what the Client wants

• Be reliable in keeping appointment(s). 

• Listen to their personalized hypnosis audio for a minimum of 21 days. 

• Be honest and open in their conversations with Krystal. 

• Be open to feedback and constructive challenge as and when appropriate. 

• Be 100% committed to taking responsibility for their own development, decisions, choices, and actions, and take the time to participate fully. 

Therapist/Practitioner Responsibilities 

What you can expect from Krystal is to: 

• Be 100% committed to empowering the Client and supporting their toward achieving their

• Actively listen and help you explore your ideas, thoughts, beliefs, values, feelings and behaviors, without imposing my own ideas, beliefs, values, feelings or behaviors.

• Be empathic and non-judgmental.


All the information from the sessions is completely confidential and will remain between the Client and Krystal except in the following circumstances: 

• There is a life-threatening situation or if the Client is an imminent danger to themself or others. 

• There is a requirement to share information by law. Krystal will keep notes of each session to record key themes discussed, insights, takeaways, and actions agreed upon.

Krystal will not disclose any information from the sessions to any parties without the Client consent


Communication will be open and honest about the therapeutic relationship itself. 

In the unlikely event that there is a breakdown in the therapeutic relationship, inadequate commitment to the process, or a lack of progress being made, either the Client or Krystal can request a termination of the Agreement within one week’s written notice. 

Have you read the agreement terms and want to consent to coaching and hypnotherapy with Krystal Rose?
Yes, I consent
No, I do not consent
Date and time

Your Commitment

You [the Client] agree to attend all scheduled sessions with an open mind and willingness to try the exercises. You are not required to do or say anything that does not align with your values, violates any personal boundaries that have been clearly communicated, or share personal information you want to keep private. You understand that success is subjective and that Krystal will do her best to provide professional experience and expertise however coaching cannot guarantee an increase in financial gain, a new job, or new relationships. It can only help you in shifting your mindset to create your own desirable outcomes and reach goals.

Are you committed to coaching?
Yes, I understand and commit to coaching
No, I cannot commit to coaching
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