Terms of service
Confidentiality Agreement and Session Terms
This agreement is made between Safa Al-Chami, a strategic psychotherapist
and clinical hypnotherapist and ________________________ ("Client"),
effective _______________
Confidentiality:
1. All information disclosed during sessions, including but not limited to
verbal communication, written materials, and personal history, is
confidential and will not be shared with any third party without the
Client's explicit consent.
2. Confidentiality may be breached if the Therapist believes the Client is at
risk of harm to themselves or others, or if there is a risk to the Client's
safety in their environment. In such cases, the Therapist may disclose
relevant information to appropriate authorities or individuals to ensure
the Client's safety.
Session Details:
1. Sessions will last between 60 to 90 minutes, as mutually agreed upon
by the Therapist and the Client.
2. If the Client cancels two consecutive sessions without adequate notice
(at least 24 hours prior to the session), a fee of $200 will be charged to
the Client.
3. Sessions can be rescheduled if cancelled with sufficient notice.
4. The Client may pause their sessions for up to 12 months, after which
the sessions will be considered terminated unless otherwise agreed
upon.
Package Details:
1. If the Client decides to terminate the Agreement before completing the
agreed-upon sessions, no refunds will be provided for unused sessions.
Appointment Policy:
1. The Therapist will hold the scheduled timeslot for up to 20 minutes
after the scheduled start time. If the Client is more than 20 minutes
late, the session will be considered a no-show, and the Therapist
reserves the right to charge accordingly.
Agreement Acceptance:
By signing below, the Client agrees to the terms and conditions outlined in this
Agreement. The Client acknowledges that they have read, understood, and
agree to abide by these terms.
Client's Name (Printed): _______________________
Client's Signature: ___________________________
Date: _______________________
Therapist's Name (Printed): ________Safa Al-Chami_______________
Therapist's Signature: ______________Safa Al-Chami_____________
Date: _______________________