Client Consent Form

As a new client, please take the time to read the following information with regards to your confidentiality and appointment times.

Confidentiality

As a client, the information you provide during your session is confidential. This means that your information will not be disclosed to others unless written permission is sought from you. However, if you have been provided with a referral, there will be brief written correspondence with the referrer regarding the treatment provided.

Although information is kept confidential, there are times when ethically and legally, it is necessary for some information to be revealed for the safety of yourself or others.

Your counsellor will not provide information about clients unless:

1. You ask them to break confidentiality because you consider that to be in your best interest.
2. There is a risk of harm to you or to someone else. The Counsellor's Duty of Care may require steps to be taken to minimise any danger. Where possible, a proposed course of action would usually be discussed with you first.
3. The Counsellor is legally compelled by a court of law, or a specific piece of legislation makes disclosure mandatory. For instance, if your counsellor is informed about a previously unreported matter of criminal nature, they may have an obligation to inform the authorities.

If you have any concerns about confidentiality, please discuss with your counsellor.

Cancellation/Non-attendance Policy

Please be advised that a cancellation policy applies for all of your sessions. Due to the waiting list that exists, when notice is not given for a missed session, it results in a client missing out on a possible session. Furthermore, no remuneration is received for this lost appointment hour.

A cancellation/non-attendance fee applies for any missed sessions when less than 24 hours notice is given. If cancellation is due to illness or other inevitable circumstances, it is at the counsellor's discretion whether the cancellation fee applies.

Cancellation fee is 50% of the current session fee.

I declare that I have read and understood the above information. I consent to the above confidentiality and cancellation policy. I consent to be a client with Calmer Seas Counselling and understand my right to retract my consent at any time.