Hypnotherapy Registration
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  9. Please upload documents in PDF, doc or docx (Microsoft Word) format. Documents larger than 5MB should be uploaded in a ZIP format. If you have some other document type, please create a ZIP file for upload. Images for drivers license should be jpg, png or in a ZIP file.
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  14. Payment Information

    I agree to pay $1,995 for 75 hours of hypnotherapy education provided by Dr. Carol L. Clark. I understand that this program is designed to meet the criteria for hypnosis as specified by Florida Administrative Code 64B4-6.006 Approval of Continuing Education Providers of Hypnosis Training Programs. Continuing Education provided by Dr. Carol L. Clark, Provider #50-550/BAP585 Florida Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling, expires 3/17; the Florida Board of Nursing, expires 10/17; and the Florida Board of Psychology, expires 5/18. This course (#20459650) is approved for 75 CEUs.

    I understand that completion of this program does not guarantee that I will be certified by any hypnosis or hypnotherapy board. I will need to submit an application to any board from which I seek certification and Dr. Carol L. Clark will provide confirmation of my training.

    I understand that if I choose to make two payments of $997.50, I am liable for payment in full by the final class in September 2016. I understand that if I make payment in full, there will be no refunds if I do not complete the program. I understand that I will need to complete 25 hours of hypnotherapy practice between the first and the second class blocks.

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