Registration Form – Supervision:
  * required field
First Name: *
Last Name: *
Mobile Phone: *
Email: *
Email confirm: *
Current Primary Occupation:
Please state any Hypnosis, NLP and any therapy training that you have:
Length of Training?:
How long ago did you graduate the training??:
How do you feel now as a therapist?:
What are the questions and issues you have as a therapist?:
How many clients a week do you see?:
What would you like to achieve in supervision, and as a therapist?:
How would you like to feel/ behave /see yourself as a therapist?:
Can I add you to my mailing
list for updates?
Terms and Conditions
Please read carefully
1. A prerequisite for supervision is to read the code of ethics of the AHA (Australian Hypnotherapists Association) which you can easily find on their website (or if you are a member of another professional association, read their code of ethics), so you can be familiar with it and act accordingly.
2. In order to gain the most benefit from Supervision it is the supervisee’s responsibility to participate to their best ability. It is best when supervision is pre-scheduled for certain intervals such as once a month/ fortnightly etc. However, contact the supervisor with any important professional dilemma without delay.
3. There is no charge for late cancellations, we work on the basis of mutual respect, please give at least 24 hours notice for any changes in a scheduled supervision session.
4. Hypnotherapy may be unsuitable as a therapy for people with certain mental health conditions such as schizophrenia and bi-polar disorder. Supervisees with such conditions must discuss it with the supervisor PRIOR to any supervision.
5. As part of supervision, at times therapeutic techniques will be demonstrated. I consent to supervision which may include at times segments of therapy by hypnotherapy and NLP with Yael Reiss and understand that this therapy should never be used as a substitute for medical treatment.
  I have read and understand the above Terms and Conditions.