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Quantum Healing Hypnosis Techniqueâ„ 
Consent & Liability Form

Please fill out the following form in order to participate in QHHT® Session(s).

Are you currently under the care of a physician?
Have you ever had a past life regression or QHHT session before?

I, herewith, voluntarily agree to sign this agreement and I fully understand that Jordyn of Lead By Light, LLC is going to perform a QHHT® session that includes hypnosis techniques. Jordyn of Lead By Light, LLC is not, nor claims to be, a doctor, nor has a degree in Psychiatry, and can neither diagnose or treat any type of physical or mental disorder.

I understand that:

  1. I am participating in this QHHT® session by my own free will & I want to be here.

  2. I understand that I am a partner in my QHHT® experience & I agree to be hypnotized by Lead By Light, LLC.

  3. I understand that any information I provide in this session will not be shared outside of the session unless I give written consent to do so.

  4. I understand that Lead By Light, LLC will not be healing me, nor claims to be able to heal me during our QHHT® session. Any & all relief I may experience is from the experience & information I receive while under hypnosis.

  5. I understand that any suggestions or information provided in session are just that, suggestions. I am not required to accept any suggestions or information as fact & I take full responsibility for what I do with any information or suggestions received during my QHHT® session.

  6.  I take full responsibility for my actions prior, during & after my QHHT® session with Jordyn of Lead By Light, LLC. 

  7. I understand that Jordyn of Lead By Light, LLC does not guarantee healing or relief to occur as a result of a QHHT® session.

  8. I take full responsibility for my health & have:

    1. Checked with a licensed medical professional that hypnosis is safe for me. ...OR

    2.  I have opted to not check with a licensed medical professional & am choosing to proceed with my QHHT® session at my own risk.

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DISCLAIMER: Hypnosis is not intended to cure any specific condition, illness, or dis-ease. Lead By Light, LLC makes absolutely no claims of a cure, or their QHHT® sessions having the ability to cure, any condition, illness or dis-ease. Individual results may and will vary. Each session is unique and its success depends on the Client’s full cooperation and faith in the entire process.

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Thanks for submitting!

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