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California Senate Bill
#SB577 Disclosure
The following disclosure is intended to fulfill the requirements of California Senate Bill #SB577 passed in September 2002, affecting all non-licensed helping professionals offering alternative health care.
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1. Geoff Mires Jr. is a Certified Clinical Hypnotherapist, Reiki Practitioner, Energy Therapist, & Shamanic Practitioner. He is not a licensed physician. He is not qualified to diagnose, treat or prescribe for physical or mental conditions.
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2. The use of Hypnotherapy, Reiki, Energy Therapy, and Shamanic practices are alternative and complimentary to healing arts services licensed by the state of California.
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3. The services offered at Geoff Mires Clinical Hypnotherapy are not licensed by the state of California, but Geoff Mires Jr. has received training that has been approved and registered by The California Bureau of Private Postsecondary and Vocational Education, The International Board of Regression Therapy, The Professional Board of Hypnotherapy, The California Board of Registered Nurses, and The California Board of Behavioral Science.
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4. Services offered include Hypnotherapy, Reiki, Energy Therapy, and Shamanic Practices for the purpose of pain management, goal setting, performance enhancement, self-healing, regression therapy, spiritual emergence issues, trauma, relationship issues, learning enhancement, stress management, career issues, exploring life purpose, personal growth and discovery. None of these services are intended to be a substitute for medical or psychological care. Any issue beyond the scope of Geoff Mires Jr.'s training and practice will be referred to a licensed practitioner.
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5. It is the goal of Geoff Mires Clinical Hypnotherapy to provide clients with a safe, non-judgmental and supportive environment where clients can gain insights into established patterns of behaviors and work towards transformation and personal growth. Because all of the services and modalities are based on the empowerment model, all clients do their own works and healing with the guidance of a co-creative facilitator.
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6. Geoff Mires Jr. has completed the California approved 200 hour training in Hypnotherapy as well as a 150 hour Clinical Internship and he is a Certified Clinical Hypnotherapist.
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7. Geoff Mires Jr. is also trained in EFT, Reiki, and Shamanic Practices.
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Thank you!

Parent Permission
to work with a Minor
My Child
Has my permission to work with Geoff Mires Jr. for the purposes of:
Parent/Legal Guardian

Thank you!

1 Hour Session

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