The Center For Transpersonal Hypnotherapy

2721 Juniper Lane
Phoenixville, PA  19460

eMail:  Caesar@tcfth.com

If You would like to set up a telephone interview to order a CD
of a personalized hypnotic session for $49.95 + $7.00 s&h,
please fill out and submit the following form:

All fields are required. All information will be held strictly confidential. We do not rent, sell, or share personal information about you with other people or companies. We will only use this information to fulfill your requests for our services.
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Please read the following "Informed Consent / Legal Consequences" form:

The Nature of Hypnosis: Memory is imperfect, whether or not hypnosis is used. Memory is not like a tape recorder, and rarely will all the details of any recollection be fully accurate.  People have been shown to be capable of filling in gaps of memory, of distorting information, and of being influenced in what is “remembered” by leading questions or suggestions. For example, our memories may sometimes be influenced through reading, movies, TV, or conversations. Thus, research has shown that there is no guarantee that information remembered through hypnosis (or through ordinary recall) is factually accurate. On the other hand, information that is so remembered through hypnosis may in fact be accurate. But, the only way one may know definitively whether something recalled under hypnosis is accurate is to obtain independent corroboration. Thus, if you should remember something under hypnosis, regard this information as simply one more source of data that cannot be relied on as more accurate or necessarily superior to material already in conscious awareness. Such further data would simply be information to be weighed and evaluated in therapy along with what you already consciously know.

Potential Legal Issue: In many jurisdictions, courts have held that a person who has been hypnotized cannot testify in court about anything remembered during or after the hypnosis. Consequently, if I consent to hypnosis, there is a possibility that anything I remember once the hypnosis begins will not be admissible in a court of law. The only way to fully protect my potential right to testify is to forego the use of hypnosis.

Release From Liability: I understand that, because of the rulings of some legal authorities, there may be limitations placed on my ability to rely on my recollections after hypnosis for purposes of litigation. For example, there is a possibility that anything I remember once hypnosis begins, may not be admissible in a court of law. I acknowledge that Caesar Muzzioli has advised me that if I have any concerns about the legal consequences of hypnosis, that I should consult with my own attorney prior to the use of hypnosis. I hereby agree, freely and voluntarily, to undergo hypnosis. I further agree to release and hold harmless Caesar Muzzioli and The Center For Transpersonal Hypnotherapy from any claims arising from the use of or inability to use my recollections, the therapist’s notes, or any other limitations on my or the therapist’s testimony in a courtroom or forensic setting. In consenting to hypnosis, I hereby agree that I do not have a cause of action against Caesar Muzzioli and The Center For Transpersonal Hypnotherapy based on his professional and competent use of hypnosis with me.  

I Consent.

   

When you submit this form, you will be taken to our intake form for further information and payment options.

Payment is either by VISA / Master Card / American Express / Discover or Bank Check for $49.95 + $7.00 shipping and handling for USPS Express Mail service.

If at anytime in the intake process* I determine that hypnosis is not the right course of treatment for your presenting issues, you will receive a full refund of your payment within 48 hours of said determination.

*(either after review of your intake form or at the conclusion of our telephone conversation)

 

 
 

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