Thank you for taking the time to complete this form. Your Name (required) Your Address (required) Your Email (required) Your Date of Birth (required) I hereby consent to receiving Solution Focused Hypnotherapy from Kate Mitchell of Swift Hypnotherapy, in accordance with the Therapy Agreement. I consent to my details being used for marketing purposes by Swift Hypnotherapy, such as occasional emails containing links to free resources, special offers etc. Clients are able to unsubscribe from emails at any time. At no point will Swift Hypnotherapy make my details available to 3rd parties. I have been issued with the GDPR Policy for Swift Hypnotherapy, and I am aware that due government guidelines this contains an additional clause regarding COVID-19. I have been issued with Swift Hypnotherapy’s Therapy Agreement. I am aware that for face to face therapy to commence I must return the COVID-19 form to firstname.lastname@example.org 24 hours prior to the appointment, and will be required to confirm these points in person at the start of the session. This is in line with the government's current guidelines. By clicking on the submit button below you agree to the above statements.