Bookings

Name *

First Name

Last Name

Phone *

(###)

###

####

Format *

In-person (139 Nelson Place, Williamstown, Victoria, Aus)

Online

Preferred Time (will be confirmed by Jacqui or alternative options will be provided) *

Hour

Minute

Second

AM PM

Consent *

I provide full consent to receiving integrative therapy sessions from Jacqueline Thomson. I understand that hypnotherapy and any other therapy or information provided by Jacqueline Thomson is not a replacement or substitute for medical, psychological or psychiatric treatment. If I have any doubts or concerns about my health, I will seek advice from an appropriate qualified healthcare professional. I understand that results may vary from person to person and that Jacqueline's offerings in no way imply or guarantee the resolution of any presenting issues or problems. Additionally, I agree that if I am an employee or a patient of Peter MacCallum Cancer Centre, I will notify Jacqui prior to our session.

I agree and consent