Consent Form
Psychological and Coaching service
Welcome, our aim is to provide you (and your family) with a professional service, in a safe and friendly manner. As part of providing a psychological service to you, we need to collect and record personal information from you (and your family) that is relevant to your situation.
Information Collection and Storage
Personal information is gathered as part of your assessment and treatment, is kept securely, and in the interests of your privacy, used only by your psychologist and the authorised personnel of the practice (as necessary). 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. Psychologists keep records for a minimum of seven years since last client contact, unless otherwise specified by other legal instructions. A more detailed description of information related to your privacy is provided in the practice’s “Privacy policy”, which can be viewed on the website (erintoddpsychology.com.au) or obtained by emailing erintodd.psychology@gmail.com. The Privacy Policy contains information about how to access, and seek correction of your personal information, and how to lodge a complaint about our management of your personal information.
Confidentiality
All personal information gathered by the psychologist during session will remain confidential except when:
1. It is subpoenaed by a court or authorised by law (this includes case notes, and any electronic communications);
2. Failure to disclose would place you or another person at serious risk;
3. Your prior approval has been obtained.
It is standard practice that letters are sent to the referrer during the course of treatment. We also send copies to your GP, if they are not the referrer. Please talk to your psychologist if you have questions or concerns about this.
Online Psychology Services
Online counselling is becoming more popular and there is a growing body of evidence supporting the effectiveness of this method. Unfortunately, there is no complete secure transmission of information over the internet, so although we will do our best, we cannot guarantee complete privacy. Clients should therefore make your own assessment of the potential risk to the security of your information through this method. Please see our privacy policy for more details.
Fees
The cost of a standard consultation (usually around 50 minutes) is $150. This and more detailed information about our fees can be found on the following website: www.erintoddpsychology.com.au under the Fees and Rebates section.
Cancellation Policy
If, for some reason you need to cancel or postpone your appointment, please provide at least 48 hours notice, otherwise you may be charged for the cost for the session.
Please note: The Charter for Clients of APS Psychologists explains your rights as a client and can be viewed at www.psychology.org.au/Assets/Files/APS-Charter-for-clients.pdf. This service is voluntary and you can withdraw your consent whenever you would like. However, please feel free to contact Erin Todd, if you have any questions and concerns, as we would like to have the opportunity to address issues as they arise.
Please note: If, after reading this page you are unsure of what is written or have any questions, please discuss it with your psychologist before signing.