| Counseling Session
Couples Counseling Session
$100.00/Session 1 hr.
|Hypnosis Session/Guided Imagery
$ 150.00.Session 1 1/2 hr
|2 Ways to Purchase a Session
1. Purchase a Counseling Session or a Hypnosis by clicking on the
PayPal Button above and pay with your Paypal account. with
MC/Visa or bank acct thru Paypal .
2. Pay with your MC/Visa/Discover by calling my offfice at
BY APT: TELEPHONE SESSION (314)731-7667
For Skype Appointment
Call my office for Skype Appointment (314)731-7667 and/or email
me at firstname.lastname@example.org
Skype Video Online Session
$ 150.00/Session 1 1/2 Hr
| CONSENT TO TREATMENT- SKYPE ONLINE SESSIONS
I _________________________________(New Client) consent to treatment from
Connie Trunk,LPC,NCC,NBCCH, Therapist, dba New Beginnings Therapy
Center,L.L.C. My choice is voluntary and I understand that I may terminate therapy at
any time, 24 hr notice cancellation policy,
I understand that there is no guarantee that I will feel better, because I cannot predict
Human Behavior and I understand that Counseling Session and/or Clinical
Hypnotherapy/Hypnosis/Guided Imagery Session, and/or Therapy Session is a cooperative
effort between me and my Therapist. I will work with my Therapist in a cooperative
manner to resolve my difficulties. I understand that fees are non-refundable.
I understand that state and local laws require that my Therapist report all cases in which
there exists a danger to self or others. I have read and have explained to me the basic
rights of individuals who receive services from Connie Trunk, LPC, NCC, NBCCH, dba
New Beginnings Therapy Center, L.L.C. These Rights:
1. The right to be informed of various steps/activities involved in receiving services.
2. The right to confidentiality under federal/state law relating to receipt of services.
3. The right to humane care & protection from harm, abuse, or neglect.
4. The right to make an informed decision, whether to accept or refuse treatment.
I have reviewed/recieved the Privacy Notice & Confidentiality Notice. I have read and
understand the above. I understand that fees are non-refundable for Counseling Sessions
and/or Clinical Hypnotherapy/Hypnosis/ Guided Imagery Sessions and/or Therapy
Sessions by Connie Trunk dba New Beginnings Therapy Center LLC.
By buying a session, I agree to the terms above.
To Purchase a Session, click on the Pay Pal Buy Buttons or Pay by Phone (314)731-7667
|Reiki Distant Healing.
IF YOU WISH, YOU MAY DONATE TO THIS SITE
I AM GRATEFUL FOR YOUR DONATION,
THANK YOU, CONNIE