HMI Enrolled Students

Forms and Form Examples

Note: Links to student forms do not open in a new browser window. Use your browser back button to return to this page.

Business License Forms

• City Business License for Los Angeles (Acrobat .pdf 2.3MB)

Hypnotherapists Union Membership Forms

• Hypnotherapists Union Local 472 - Membership Application
  (Excel .xls 27k)
• Hypnotherapists Union Local 472 - Upgrade and/or Badge Order
  (Excel .xls 20k)

Liability Insurance Forms

• Application for Professional Liability Insurance for Certified Hypnotists
  (.pdf 1.9MB)
• Example of Completed Liability Insurance Application
  (.pdf 2.0MB)
  • More information on Professional Liability Insurance from the AHA

Marketing Letters

• Announce Grand Opening of Private Practice (Word .doc 20k)
• Gift Certificate Cover Letter (Word .doc 21k)
• Gift Certificate Cover Letter for New Year (Word .doc 21k)
• HMI Practice Starter Kit Order Form (.pdf)

Private Practice Forms

• Acknowledgement of Services and Fees (Word .doc 24k)
• Application - Personal Data Record and Release (Word .doc 26k)
• Consent to Release Information (Word .doc 22k)
• Disclosure of Services (Word .doc 31k)
• Food Guide (Excel .xls 39k)
• HMI Internal Disclosure to Clients (HMI Clinic Use) (Word .doc 23k)
• Life History Questionnaire  (.pdf 17k)
• Outside Client Verification Form (.xls 20k)
• Parental or Custodial Consent (Word .doc 23k)
• Progress Report (Excel .xls 26k)
• Request for Medical Referral (Word .doc 23k)
• Request for Medical Referral - Reply (Word .doc 24k)

Private Practice Forms - Questionnaires for Sexuality

• Female Sexuality Questionnaire 1 (Excel .xls 22k)
• Female Sexuality Questionnaire 2 (Excel .xls 21k)
• Male Sexuality Questionnaire 1 (Excel .xls 21k)
• Male Sexuality Questionnaire 2 (Excel .xls 26k)

Private Practice Forms - Questionnaires for Suggestibility

• Suggestibility Questionnaire 1 (Excel .xls 21k)
• Suggestibility Questionnaire 2 (Excel .xls 21k)
• Suggestibility Questionnaire Score Chart (Excel .xls 20k)

Distance Education Students

• Clinical Hours Grid

HMI Southern California Hypnotherapy Clinic Location

Hypnosis Motivation Institute
18607 Ventura Boulevard, Suite 310
Tarzana, California 91356-4158 USA
1-818-758-2747 · Fax: 1-818-344-2262
Toll Free: 1-800-479-9464

Get Directions to HMI from Google Maps

Last modified: 2008-04-27T17:19:07-0700