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BQH Hypnosis Intake Form 

Thank you for your interest in booking a Beyond Quantum Healing session with me! I am looking forward to facilitating this experience for you.

Please fill out this form to initiate a BQH session with me.

Gender Identifcation *
Marital Status *

Responsibilities and Liability Release

1. I am willing to be guided through relaxation, visual imagery, hypnosis, and/or stress reduction techniques. I am aware these modalities are non-medical in nature and it is my responsibility to consult my regular doctor about any changes in my condition or changes in my medication.

2. I understand the above modalities are not substitutes for regular medical care and I have been advised to consult my regular medical doctor or health-care practitioner for treatment of any old, new or existing medical conditions.

 

3. I understand that change is my own and complete responsibility. I understand that ALL HEALING IS SELF HEALING and that Kristy Engelke is only a “facilitator” in the process of helping me to solve my own problem(s). It is my responsibility to be open and honest, provide accurate feedback and be forthcoming with details and information that may help me achieve my outcomes.

4. I understand that any details or insights that arise during the session are solely for personal education and introspection purposes. I understand that any transformation or change is a process and will take time to evolve.

 

5. I understand that this hypnosis session is solely for educational and entertainment purposes. The hypnosis session is not a substitute for medical or psychological advice from a medical or mental health professional. Only a medical professional or mental health professional can provide medical or psychological advice.

6. I understand that being hypnotized is not being asleep or unconscious. While in a deep trance, I may have the ability to open my eyes, move my body, voice my thoughts, hear outside noises, and even be aware of everything that is going on around me. (Note - It is very common these days that clients remember their sessions)

 

7. I understand I may be assigned “homework” or be asked to make changes to my life by my Higher Self in regard to complete or solidify any healing or changes begun in our session today. I understand that this information and advice for change comes not from the BQH facilitator, but from my own higher being.

 

8. I understand that my facilitator may elect NOT to proceed with the session if she/he feels it is not in their or your best interest to do so. My Facilitator is NOT liable for travel costs (airline, hotel, etc.) associated with declining a session.

 

9. I understand that our session will be digitally recorded for my later use. I also understand that in these types of metaphysical sessions, the energy in the room can affect the equipment and recording resulting in static or blank recordings.

10. I understand that Kristy Engelke is not a licensed physician; her services are not licensed by the State of California, and that her services are alternative or complementary to the healing arts services that are licensed by the State of California. 

 11. I agree to full release and hold harmless Kristy Engelke from and against any and all claims or liability of any nature arising out of, or in connection with, my sessions.

By signing electronically, I accept the terms and conditions of the Responsibilities and Liability Release and I confirm that my information is accurate and true.

Special Use Information

I understand that my name and personal information will be kept completely confidential.

 

I understand that I may share my recording and information in the future in any way that I am personally comfortable.

 

I understand that often in BQH sessions, universal information is provided through the client to benefit all of humanity. I agree to allow Kristy Engelke to share this information and any accompanying story summary either in audio or video or in written form in blogs or books as long as my identity, name and all relevant personal details are omitted or changed.

Thanks for submitting!

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