

Follow-up visits may be scheduled for 75 minutes or two hours and can include a hypnosis session if desired.
All sessions can be recorded for your future use if desired, at no additional cost.
Please specify on the intake form the area(s) of concern you wish to address.
If you would like additional information before scheduling, please feel free to call or text Dr. Heller at 602-502-4000 or email DrHeller@phoenixhypnosismd.com.
Dr. Heller is a licensed physician in the state of Arizona. During these sessions he works with clients in the role of hypnotherapist and performance coach rather than as a treating physician.

Hypnosis Disclaimer and Release Form
-
The undersigned acknowledges that the services provided are for the purpose of hypnosis and are not intended to diagnose, treat, or cure any medical or psychological conditions. If you have any concerns regarding your medical condition please speak with your doctor or other medical professional first.*
-
The undersigned understands that engaging in hypnosis does not establish a physician-patient relationship. The services provided are not a substitute for medical or psychological treatment.
-
The undersigned confirms that they have been informed about the nature of hypnosis and its potential benefits and risks. They have had the opportunity to ask questions and have them answered to their satisfaction.
-
The undersigned releases Dr. Lewis Heller/ and Medical Hypnosis Institute, their employees, and agents from any liability for any injury or damage that may arise from the hypnosis sessions.
-
By signing below, the undersigned acknowledges that they have read and understood this disclaimer and release and agree to its terms.
