Client Bill

Bill of Rights

Name
MM slash DD slash YYYY
My name is Tina Pineiro, Hypnotist & Coach. My office is located at 742 Main Street, Suite 201, Honesdale, PA 18431. I can be contacted at (570) 352 3048.
Related Education and Training:
I received my NGH certification training at New York Hypnosis Training Center, a NYS licensed school, in Holbrook, New York and I receive annual continuing education to maintain my skills at a high level.

Redress: I am a certified member of the National Guild of Hypnotists, and practice in accordance with its Code of Ethics and Standards. If you have a complaint about my services or behavior that I cannot resolve for you personally, you may contact the National Guild of Hypnotists at P.O. Box 308, Merrimack, NH 03054-0308, (603) 429-9438, to seek redress. Other services than my own may be available in the community. You may locate such providers on the internet.

Fees: The fees for my services are $150 per session.

Confidentiality: I will not release any information to anyone without a written authorization from you, except as provided for by law.

Insurance: In general, insurance companies do not cover hypnotic services. Therefore, you will be paying me directly for my services.
The services I render are held out to the public as non-therapeutic hypnotism, defined as the use of hypnosis to inculcate positive thinking and the capacity for self-hypnosis. I do not represent my services as any form of medical, behavioral or mental health care, and despite research to the contrary, by law, I make no health benefit claims for my services.

Your submission of this form indicates that you have read and understand this Client Bill of Rights:
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