My name is Robert S. Gutkin, CH. I can be
contacted at my home office, PO Box 308 209 Accord, NY 12404, through e-mail: robert.gutkin@gutkin.org or by telephone at 845-706-3850. In 1995
I was trained in the art and science of hypnotism by Richard A. Zarro, CH, C.I. at Futureshaping Technologies,inc in Woodstock, NY. Mr. Zarro is a Certified Instructor with the National Guild of
Hypnotists. The Guild is the oldest and largest organization dedicated to Hypnotism. Certification in the National Guild offers the most
widely recognized credentials for the professional practice and training of hypnosis.
Notice: AS THE STATE OF New York HAS NOT ADOPTED EDUCATIONAL AND TRAINING
STANDARDS FOR THE PRACTICE OF HYPNOTISM, THIS STATEMENT OF CREDENTIALS
IS FOR INFORMATIONAL PURPOSES ONLY. Hypnotism is a self-regulating profession and its
practitioners are not licensed by state governments. I am not a physician nor a licensed health care
provider and may not provide a medical diagnosis nor recommend discontinuance of medically
prescribed treatments. If a client desires a diagnosis or any other type of treatment from a different
practitioner, the client may seek such services at any time. In the event my services are terminated
by a client, the client has a right to coordinated transfer of services to another practitioner. A client
has a right to refuse hypnotism services at any time. A client has a right to be free of physical, verbal
or sexual abuse. A client has a right to know the expected duration of sessions, and may assert any
right without retaliation.
Redress: I am a certified member of the National Guild of Hypnotists, and practice in accordance with its Ethics and Standards. If you have a complaint about my service or behavior that I cannot resolve for you personally, you may contact the National Guild of Hypnotists at P.O. Box 308 Merrimack, NH 03054-0308, (603) 429-9438, to seek redress. Other services than my own may be available to you in the community. You may locate such providers in the phone book.
Confidentiality: I will not release any information to anyone without a written authorization from you, expect as provided by law. You have a right to be allowed access to my written record about you.
Payment: I do not except Insurance or credit cards.
My Approach:
The client and I discuss and then focus on a specific goal. I coach my clients to achieve a state of hypnosis. Self-hypnosis is the skill of being able to induce the relaxed state of hypnosis on yourself. As a hypnotist I use artful ideas to induce a state of hypnosis- a relaxed mental state (alpha state) in which the client's mind is most available and open to suggestion. I often use the Erickson allegory technique in which the subconscious takes the appropriate information necessary to help resolve the desired goal.
Client Signature: I have received and read this Client Bill of Rights and understand what I have read.
Client Name:___________________________________________________
Client Address:__________________________________________________________________________________________
Client Contact information: email______________________________________ Phone: _______________________________
Client Signature:________________________________________________
Date ____________________________________