Terms and Conditions - Consent for Therapy

Name of Practice/Clinic/Counsellor: Incognito Counselling / Ivan Dragostinov

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Website: www.in-cognito.com.au

The ethics of our profession demand that we respect the dignity and integrity of those who seek our help. While we are always ready to listen to unusual circumstances and to help in any way possible, we expect that our clients will give us the same respect for dignity in our professional and personal lives that we try to offer. Your signature on this sheet will indicate that you have read and understood it and agree to its provisions.

Confidentiality: The legal environment in New South Wales, Australia requires the following clarifications regarding issues of confidentiality.

1. If you are an adult, anything you do or say in the context of psychotherapy is private with these exceptions: a. If you are behaving in a way that poses a threat of a physical nature to another person, privilege is waived. Therapists are bound by law to contact the person involved and warn of the possible danger. b. If child abuse has occurred we also must report the abuse by law. I will however, work alongside you to help resolve this situation. c. If you are using confidentiality as a means of avoiding legal punishment, privilege is waived. That is, psychotherapists may not aid or abet the perpetration of crimes. Of course, all actions taken under these provisions will be discussed with you fully and in advance, whenever possible.

2. Parents or guardians of minors hold the privilege, and are entitled to information communicated by their children in psychotherapy. Two exceptions to this rule relate to teenage pregnancy and/or drug abuse. Ethics require me to communicate information regarding your child only in ways that will be helpful.

Fees & Attendance: Fees are set at the beginning of a course of therapy. All fees are expected to be paid at time of service delivery. Sessions may need to be missed from time to time. I will try to reschedule if possible. If sessions are missed without 24 hour notice given, the session will be charged at the regular fee. Any sessions in 'The Local Pub' will not involve the consumption of alcohol.

Online/Video/Phone Sessions: Occasionally, sessions may occur remotely (e.g., via video or phone) as agreed upon. Please ensure you are in a private and secure location during these sessions to maintain confidentiality.

Emergency Contact: Should you have a psychiatric emergency and are unable to reach your counsellor, please call 000 or go to your local emergency room or contact other services such as Beyond Blue/Lifeline.

By reading this I understand and agree to the above statements and consent for counselling therapy with Ivan Dragostinov.

If there are any issues please let me know:

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