East Maitland Holistic Psychology Clinic
66 King Street
East Maitland, NSW 2323
Email: info@eastmaitlandpsychologyservices.com.au
Client Information and Consent Form
Psychological service
The purpose of counselling is to help you work towards solutions by developing strategies to help with your concerns. Your counsellor will decide with you how often to meet. Sessions are usually about 50 minutes in duration. This allows your counsellor time to complete all mandatory administrative tasks on your file. To help you achieve your goals, you may be given some tasks to do at home between sessions.
Privacy and Confidentiality
As part of providing a psychological service to you, East Maitland Holistic Psychology Clinic needs to collect and record personal information from you that is relevant to your situation, such as your name, contact information, medical history and other relevant information. This collection of personal information will be a necessary part of the psychological assessment and treatment that is conducted. Your informed consent will be obtained before any treatment or procedure is initiated and you may withdraw from treatment at any time without prejudice.
Your personal information is retained in order to document what happens during sessions, and enables the psychologist to provide a relevant and informed psychological service to you. You are entitled to access your personal information kept on file at any time. Should you wish to see the information kept on your client records, please discuss this with your psychologist.
Limits to confidentiality
Everything you discuss will be treated with professional confidentiality except in circumstances where:
- Disclosure is required or authorised by law when there is:
- subpoena of files by a Court;
- suspected child abuse or neglect, past or present (including past sexual abuse);
- immediate, specific risk of harm to any individual;
- if a significant crime has been committed;
- your prior approval has been obtained to provide a written report to another professional or agency. e.g. GP, school or a lawyer; or|
- when consulting with colleagues, or in the course of supervision. In this case your psychologist will be required to conceal your identity and any associated parties involved; and to preserve your privacy at the utmost professional manner in accordance with the APS Code of Ethics.
Note: If you are unclear about any of the information on this consent form, please discuss this with your psychologist at the commencement of the session.
Duty of Care
- If counselling a child who has the ability to consent to the counselling process, the counsellor will discuss with them prior to any feedback being given to parents.
- Feedback may be provided to both parents upon request, unless Court Orders specify, or the counselor is aware of risk factors, or the child makes a specific request.
Cancellation Policy
- To ensure that East Maitland Holistic Psychology Clinic provides the highest quality of care to our clients, please give at least 24 hours notice if you are unable to attend your scheduled appointment. If you do not provide 24 hours notice, or do not attend without letting us know, a cancellation/non attendance fee of $80 (50% of our full fee) will be charged and this payment will be required prior to booking your next appointment. If you are accessing counselling through your Employee Assistance Program or NDIS, the paying organisation will still be required to pay for your missed session and this will reduce the total number of sessions available to you.
- If you do not attend your appointment and do not let us know, you may receive a phone call from our friendly staff to enquire if you would like to make a follow up appointment. However, if you miss more than one appointment without notice, any future appointments will be cancelled until we hear from you. We really want you to return and see your counselor so please make every effort to keep us informed of your circumstances.