Skype Session With Michael Mahoney

Thank you for your interest in my online sessions.

These are conducted using WhatsApp which is a secure online end to end encrypted communication system.

I have listed below some important information and a personal history form. Please read, complete and return when you are ready to arrange your Initial Consultation.

Please note, that if you would prefer that we complete the form together in full or partially at the initial consultation please tick the box indicating this.

The Initial Consultation (IC) WhatsApp session lasts up to 50 minutes.

The cost is £75 please note no therapy or recording will be given at this first session.

The initial consultation is to establish your needs and history, and by so doing, this information, and other information which is shared in our discussions, will be used to create the best understanding of your needs and help the structuring of future sessions, including any recordings to be used by you.

The Initial Consultation (IC), includes the completion of an assessment form, (Unless you indicate differently - see above) and a signed agreement of this Contract. Information provided on the assessment form is deemed to be true.

Anything relevant, that you don't share, will without doubt impact outcomes, after all, we cannot make a full picture if pieces of the jigsaw are missing!

When completing this form, please remember after 36+ years in practice it is highly unlikely you can tell me anything that I haven't heard before.

You may be hesitant to tell me some things and that's understandable. However you will not be judged in any way, the goal is to help you the best I can, and that means having all the information. Think jigsaw!

The Initial Consultation session is a vital part of any future work between us, as it is beginning a process, building rapport, and exchanging information, we will have an honest, open and confidential discussion regarding your problem(s) or concerns.

I will volunteer information which I feel will be beneficial to you at every opportunity. Many people find the Initial Consultation informative, educational, and enlightening.

The initial consultation is about making sure we have the information we need to plan and structure your needs accordingly. Because we will have shared lots of information between us, we will have a good idea if we will both feel comfortable working with each other.

After the initial consultation, you are encouraged to take some time to think about everything we have discussed. It is never a good thing to just rush in. By thinking things over, and perhaps speaking to your partner or close friend about the conversation you will have a clearer idea about moving forward.

Further sessions may also include information gathering, updating, a recording and agreeing to the next step, and may involve, coaching and counselling if required.

These Follow on Sessions (FoS) are costed at the same price as the Initial Consultation £75.00 and will be used to build on the initial consultation.

In some instances, depending on what is being discussed, the sessions will be more in-depth and focused entirely on the problem. This of course is done in a gentle, sensitive way.

Many (FoS) lead to an MP3 being made for you and sent to you by email or via Dropbox or a similar sharing platform. Any MP3 is normally completed within 3 days. If any delay occurs you will be notified.

Please note, that where counselling or coaching has been conducted, no MP3 recordings will be provided.

As we progress, when you have multiple recordings, I will provide, where needed a suggested listening schedule, free of charge, which you are encouraged to follow. Follow on Sessions (FOS) are £75, including any hypnotherapy recording provided. Hypnosis is never carried out in online sessions. I prefer to take a little time to think, plan and structure your recording before starting it.

MP3 files sent to you should only be used by you, the intended listener. I will accept no responsibility for the correct use or outcomes of any recording which is provided at my discretion.

The agreement to work on the issues presented by you in no way guarantees, nor does it suggest a cure. You, acknowledge and accepts full responsibility for all outcomes.

The only guarantee I give is that I will do my very best to help you, to the best of my ability.

On the assessment form, you are asked to provide relevant medical information, including your GP’s / Professional Health Care Provider's contact details. If advised by me at the Initial Consultation, you agree to seek medical approval before commencing any online sessions.

The cost of each following online session is £75 including an MP3 download if applicable. (Priority appointments add £15)

Payment by PayPal is due 48 hours prior to the agreed commencement time and date of each session.

PayPal Payments to be sent to timelineservices@aol.com
Once payment is made, we will confirm receipt and appointment.

Once confirmed no refunds will be made.

(Why?) this is because time will have been allocated to you which cannot be used for others. Also, some time spent and work will have been done before the session.

Please note. Prompt payments are appreciated and are your responsibility.

No reminder for payment from me or my associates will be sent.

If payment is not received 48 hours prior to the planned session, all planned and future sessions will be cancelled and the agreement terminated.

(Seems a little harsh? Why?)

This is because I believe time is important. We can never get a single minute back. My time is important to me, more important than money. In fairness, most people don't forget but it has happened, so being upfront and open about it is only fair.

Confidentiality:

Confidentiality will be maintained in all but the most exceptional circumstances. These can only include legal action (criminal or civil cases where a court order is made demanding disclosure - including coroners courts) and where there is good cause to believe that not to disclose would cause danger of serious harm to the client or others.

Most standards of confidentiality applied in professional contexts are based on Common Law policy where the duty to keep confidence is measured against the concept of "greater good". ‘Safeguarding of Children & Vulnerable Adults’ guidelines will always be adhered to. (Law of England & Wales applies)

The sharing of anonymous case histories with supervisors and peer support groups is not a breach of professional confidentiality. The sharing of open case histories with supervisors and any referring NHS medical practitioner is also not a breach.

Any written records kept by the practitioner will be destroyed after 60 days of the final session.

Please note, While online providers (WhatsApp do their best to ensure secure and private communication, no guarantee by the providers is made of 100% security, despite the encryption methods employed by the providers of WhatsApp)

Appointments are available where indicated. Please note UK Bank Holidays and Weekend appointments are not available.

A few words about me - since we are both sharing information!

I have been in practice since 1986 and spent more than 25 years based in medical centres, and hospital environments seeing referred and private clients and patients.

I have always been one for wanting to help where I can since I was a child and continue that desire to this day. I am known for my honesty, patience, humour and gentleness, I am married and a confessed tree-hugger. Loving the outdoors taking any and every opportunity to be out in nature walking.

I have won innovation and research awards for my work in IBS, a common gastrointestinal condition, and emotional recovery after breast cancer. I am the author of many innovative health solutions, (health focussed audio programs), which led to an invitation to attend the Queens Garden Party at Buckingham Palace - it was a great day!

Please only complete this form and send it back when you are ready to have your initial consultation.

Name

First Name Last Name

Occupation

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Phone Number for WhatsApp if different from above

Area Code Phone Number

E-mail

example@example.com

The information given on this form is used to assess your problem and greatly assist in preparing and scheduling our sessions together. Please answer all questions as honestly as you can. All information is confidential at all times.

Your Age

Date of Birth dd/mm/yyyy

Gender

Marital Status

Have you had counselling in the past

If Yes - When and what for. Did you find it useful?

Have you had Hypnotherapy in the past

If Yes - When and what for. Did you find it useful?

Any other comments?

How did you hear of my services?

To help me to better understand how things are at the moment for you, please select all of those below which are relevant to you at the moment.

If Other, please give as much information as you can below.

Type in the box above

Is your problem in the past

Is your problem in the present

Is you problem in the future

Do you have Epilepsy

Do you or have you ever been diagnosed with Schizophrenia

Are you taking antidepressants

Do you use recreational drugs?

Are you taking sleeping tablets

Are you taking tranquilizers

Have you ever had a nervous breakdown

If yes, What year

Have you ever had treatment from a psychiatrist

If yes, please give dates, any inpatient times and dates, and any other relevant information

Do you have any known medical illness or condition for which you are currently receiving treatment.

If yes, please give details

Have you had any sudden weight loss or gain in the last six months

Have you seen your doctor in the last 3 months

If yes please give details

Is there any other relevant information

If yes please give details

Healthcare Provider Name address and contact details.

Preference 1: What is your preferred date for the Initial consultation ( Monday/Tuesday/ Wednesday/Thursday Only) See below for priority appointment *

Date

What time do you prefer your consultation to be held (UK Time) (Preference 1) *

: Hour Minutes AM/PM Option

Preference 2: What is your preferred date for the Initial consultation (Monday Tuesday/Wednesday/Thursday Only) See below for priority appointment

Date

What time do you prefer your consultation to be held (UK Time) (Preference 2)

: Hour Minutes AM/PM Option

Priority Appointments: These are only for those who need an appointment on (Fridays or before 8.00 am or After 5:00 pm Mon-Thurs UK Time) . A premium of £15 applies. Why do you need this appointment?

Date Priority Appointment Preference 1:

Date

Priority Appointment Preference 1: What time do you prefer your consultation to be held (UK Time)

: Hour Minutes AM/PM Option

Date Priority Appointment Preference 2:

Date

Priority Appointment Preference 2: What time do you prefer your consultation to be held (UK Time)

: Hour Minutes AM/PM Option

By signing below and selecting confirmation of signature, you are stating that all the above is true to the best of your knowledge. Please note the above information is to give Michael Mahoney an understanding of your life and medical history. The information will help during the initial consultation.

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You confirm the above information is correct and the mark in the above signature box is that of the person whose name is at the top of this form.

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WhatsApp Session With Michael Mahoney