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Please tick if you have any of the conditions listed below

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I hereby give my consent for therapeutic treatment with Kate Delaney PhD Dip. Hyp. MBSCH. I understand that a blend of techniques may be used combining Clinical Hypnotherapy, Mindfulness, Eye Movement Desensitisation Reprocessing (EMDR), Neuro-Linguistic Programming (NLP) & Emotional Freedom Technique (EFT). I consent to you contacting me about my appointment using my preferred contact method. I confirm that the above information is correct and I understand that my notes will be treated as private and confidential. I understand that my information is shared in strict confidence and confidentiality will be kept unless I am considered at risk of harm to myself or others. I understand that in submitting this form I consent to therapy and agree to the above terms and conditions. *

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