Clinical hypnosis and/or H-EMDR Clinical hypnosis and/or H-EMDR (#12)Here you book an appointment for clinical hypnosis or H-EMDROnline and in person Hypnotherapy is just as effective when done online as it is in person. The classes available are: Online (via Zoom or Teams) Ármúla 23, 108 Rvk If you want to book an appointment, fill out the form you will find below. Hypnosis and H-EMDR sessions Each session lasts an average of 2 hours and costs ISK 20,000 (the session is 40,000 including VAT) if held online, but 25,000 (the session is 50,000 including VAT) if the session takes place in Ármúla 23.All about youPROVIDED IDENTIFICATION NUMBERWhat do you want to work with?In short, what is the problem you want to work on?Describe in detail the problem you want to work onIf there is more than one problem, indicate here the problem that you think is MOST IMPORTANTKeep in mind the problem you MOST LIKE TO SOLVE and check below based on how you feel nowTo what extent are the symptoms present in your life?– Select –Not applicable12345678910NOTE Lower numbers mean milder symptoms (better feeling) Higher numbers mean stronger symptoms (worse feeling)To what extent has the problem affected the following:Your social life– Select –Not applicable12345678910Your family life– Select –Not applicable12345678910Your sex life– Select –Not applicable12345678910Your spiritual life– Select –Not applicable12345678910Your memory– Select –Not applicable12345678910The sleep– Select –Not applicable12345678910Your appetite– Select –Not applicable12345678910Your job or schooling– Select –Not applicable12345678910Your concentration– Select –Not applicable12345678910Cause you worry– Select –Not applicable12345678910Cause yourself depression– Select –Not applicable12345678910Cause yourself anxiety– Select –Not applicable12345678910Choose the physical symptoms– Select –Not applicable12345678910Something else or other problemsTo what extent has it had an impact?– Select –Not applicable12345678910Have you received a diagnosis from a doctor or psychologist, e.g. ADHD, PTSD or other?– Select –YesNo diagnosticsIf applicable, have you noticed anything that makes your situation or condition worse? If so please describe it.Your goal: In relation to what we will work on together, how would you like your current and future experiences of life to be different?Where did you hear about Éxito or Guðbjörg e.g. Facebook, Instagram, LinkedIn, Google, etc.Have you experienced hypnosis before? If yes, please describe your experience and the result.Have you tried other talking therapies? If yes, please describe your experience and the result.More about youWhat is your relationship status?– Select –MarriedDivorcedLives with spouseIn a relationshipSingleOtherDescribe how you feel about your home life.What do you do for a living or what are you studying?Describe how you feel at work or studyWhat do you do in your spare time and what are your hobbies?What do you do to relax?Do you have a peaceful and quiet place that you can imagine being in during hypnosis? If so where would it be?Treatment details – please readInformation about hypnosis sessions Treatment sessions are available online and in person (Ármúla 23, 108 Reykjavík). Online hypnotherapy Hypnosis sessions are available via Zoom, Teams and phone. Subject to availability, appointments can be made Monday through Friday from 9:00 a.m. to 3:00 p.m. For online time, the customer is responsible for having sufficient internet to allow both video and audio. Phone time is only available after the first session and for speech therapy (not hypnosis). If the phone or internet connection is lost, the therapist will try to reconnect. If it fails, the client is prompted to try to connect again. The customer is responsible for providing another means of contact, e.g. phone for online hypnotherapy. Appointments Please arrive on time. If you expect to be late, call 776 1220 or send an email to exito@exito.is. If you arrive late, we will use the remaining time where possible. If you need to reschedule or cancel an appointment, please give a minimum of 24 hours notice (48 hours for Monday appointments), otherwise a 50% early cancellation fee will apply. If you do not show up on time and have not canceled or postponed, the full fee applies. Hypnosis session – duration and fees Standard hypnosis sessions are two hours long. The fee for online hypnotherapy is 20,000 ISK per hour. Hypnosis sessions where we meet at Ármúla 23 cost 25,000 ISK per hour. Price includes value added. Payment of fee I will send you a claim to your bank that needs to be paid 2 days before the booked appointment. Below you need to provide your social security number and bank details for the booking to be valid. Information provision Please provide here as honest and detailed information as possible in order to achieve the best results from our work. When we meet for the first time and later in the process, it is also very important that all the information you provide is as honest as possible. Homework Assignments or homework may be submitted as part of the process and will be approved during the meeting. Between hypnotic sessions Between hypnosis sessions, you will be asked to fill out an evaluation form the day before we meet, where you describe your experience from the last session and also evaluate the effects of the symptoms you wanted to work with as they are on the day you evaluate. Questions or inquiries If any questions arise regarding the homework or other aspects of the treatment, please contact Guðbjörgu on tel. 776 1220 or exito@exito.isTreatment agreement – please readPlease read the treatment agreement and if you agree, fill out the last section asking for your name and date. Treatment Agreement Treatment is a collaborative project between the hypnotist (Guðbjargar Erlendsdóttur) and the client (you), which is based on an agreement on the following points: I understand that the nature of the treatment will be explained to me and that I can proceed when I have sufficient information. I understand that therapy is a collaborative process between therapist and client and that both client and therapist both have a role to play and both need to participate. I understand that when I commit to tasks and activities, beyond the treatment session, they are designed to support and enhance the treatment process. I understand that the length of each session may vary, rather than being a fixed 120 minutes. I also realize that the work to be done may take more than one time. I understand that I will be asked to discuss a specific goal/strategy for the treatment. I understand that a guarantee of a successful outcome is not possible and accept that even where the Therapist performs this treatment to the best of their ability, certain results may not be achieved due to circumstances beyond the Therapist’s control. I am aware of the fee charged for the treatment and agree to pay it in the manner agreed upon before the treatment begins. I have disclosed all information that could affect the success of the treatment or my well-being. I understand that the therapist is not responsible for the recurrence of physical or mental problems prior to treatment. I give my consent for this treatment to be carried out by the therapist. I acknowledge and agree that personal information will be recorded for treatment, accounting and communication purposes and this information will be stored securely in accordance with the General Data Protection Regulation (GDPR). I understand that the therapist agrees to perform her duties with the required standards of ethics and practice and to be bound by the laws of her professional group. I (the client) give my consent to this treatment and take responsibility for the current and future conditions, both physical and mental. Account information The ID number and bank details of the payer must be provided here for the booking to be valid and a claim will be sent to the bank. Payment must be made 2 days before the booked time.Social Security numberBankLedgerAccount numberTreatment consent To accept the treatment agreement, please fill in the following information:PROVIDED IDENTIFICATION NUMBERDate of approvalSubmit form
