As part of providing a psychological service to you, the psychologist/mental health social worker will need to collect and record personal information from you that is relevant to your current situation. This information will be a necessary part of the assessment and treatment that is conducted. You do not have to give all your personal information, but if you don’t, this may mean we may not be able to provide you with a service.
Confidentiality and Exchanging Information
All personal information gathered by the psychologist/mental health social worker during the provision of the psychological service will remain confidential and secure except where:
1. It is subpoenaed by a court, or
2. Failure to disclose the information would place you or another person at serious and
imminent risk; or
3. Your prior approval has been obtained to
a) provide a written report to another professional or agency. eg. a GP or a lawyer; or
b) discuss the material with another person, eg. a parent or employer; or if disclosure
is otherwise required or authorised by law.
Full information about our fee struture can be found at www.unitedminds.org.au/fees If you are a bulk billed client, by siging this consent form you assign your rebatable rights over to United Minds in full.
You will receive an email reminder 48 hours prior to your scheduled appointment. If you need to cancel or reschedule your appointment, you are required to provide at least 24 hours-notice. Otherwise, our cancellation policy applies. This fee can be waived in exceptional circumstances at the discretion of the Managing Director.
I have read and understood the above Consent Form and I agree to these conditions for the service.