INTAKE FORMS

We understand that in this day and age, we must all be discerning about to whom and when we give our personal information. Please be assured that any information you provide goes no further than to Align Within, LLC, specifically Lisa Smole. Your information is used solely to assess your needs, preferences and potential courses of action we will take together. Your privacy is protected in filling out these HIPAA compliant online forms.

If you are a new hypnotherapy client, please complete the online Intake Forms at least 2 business days before your first appointment. For access you will need a password and you will receive that during your telephone consultation. Our work together during session time is of utmost importance and our focus will be on getting positive results. For this reason, it is preferable that you take care of administrative tasks such as scheduling and payment online prior to our session. Online scheduling and payment saves precious time and energy and assures that our session time together is spent honing in on and addressing your goals.

 

The online Intake Forms are required prior to our work together.  If you are unable to complete the intake forms before your first appointment, please let us know so other arrangements can be made. If completed forms are not received at least 2 business days in advance and other arrangements have not been made, then your appointment will automatically be cancelled or rescheduled and you will be notified.

These codes of conduct assure professionalism and that expectations are clearly defined, which frees up time and energy so that we can focus on your path of transformation. Please take a few moments to read them.

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NEW CLIENT INTAKE FORMS

These intake forms are for new clients who have a consultation or session scheduled already. Please complete the forms at least 2 business days before your first appointment. 

 
 



AUTHORIZATION FORM

 

It is Lisa Smole's standard of practice to work in partnership with other professionals so that clients receive the best care possible. The Authorization Form authorizes to release your information or to obtain your information. It is applicable only if you are under the care of a physician, psychotherapist, psychologist, psychiatrist or other health care professional for which you are seeking help with from Align Within, LLC. If you are uncertain if this form applies to you, we can talk about it together in order to determine if it applies to you.