Parent / Legal Guardian Consent Form

Student Success Hypnosis™ is designed to support students in developing greater confidence, reducing test-taking anxiety, improving focus, and fostering a calm, positive mindset for academic success.

Hypnosis is a natural state of focused attention and deep relaxation. Students remain aware of their surroundings and cannot be made to do or say anything against their values or wishes. Participation is always voluntary.

As the parent or legal guardian of the above-named student, I understand and acknowledge that:

• My child is participating in Student Success Hypnosis™ voluntarily.
• This session is intended to support personal growth, relaxation, confidence, and stress management related to academic performance.
• This service is educational and wellness-focused and is not psychotherapy, counseling, medical treatment, or a substitute for care provided by a licensed physician, psychologist, psychiatrist, or other healthcare professional.
• No specific outcomes or guarantees have been made regarding academic performance or test results.
• My child may discontinue participation at any time.

I understand that a personalized hypnosis audio recording will be created for my child to support continued practice at home.

I understand that this recording is intended solely for the personal use of my child and may not be copied, distributed, shared, sold, or reproduced without written permission from Radiance Wellness Co..

Please indicate if your child has been diagnosed with or is currently receiving treatment for any of the following:

I understand it is my responsibility to disclose any significant medical or mental health conditions that may affect participation.

I understand that if Radiance Wellness Co. believes hypnosis is not appropriate for my child, the session may be postponed or declined, and I may be encouraged to seek guidance from an appropriate healthcare provider.

Radiance Wellness Co.respects client privacy. Information shared during sessions will be treated respectfully; however, because the participant is a minor, relevant information concerning the student's safety or well-being may be discussed with the parent or legal guardian as appropriate.

I certify that I am the parent or legal guardian of the above-named student.

I have read and understand this consent form.

I have had the opportunity to ask questions, and all of my questions have been answered to my satisfaction.

I voluntarily give permission for my child to participate in Student Success Hypnosis™ at Radiance Wellness Co..

Autumn Sandoval
Radiance Wellness Co.