Informed Consent and Confidentiality Agreement / Terms and Conditions
Apart from specific exceptions described below, you have the absolute right to confidentiality of your information. You are assured that all personal information gathered by Anxiety Mentor will remain confidential and secure.
However, it is important to know there are exceptions in which all psychotherapists are mandated (by law) to break confidentiality. This can occur when:
- The information you have given to your therapist is subpoenaed (officially requested) by a court of law.
- You or another person is at serious risk of harm.
- Your prior approval has been obtained to:
- a) provide a written report to another professional or agency, eg. a MD/GP or a lawyer; or
- b) discuss the material with another person, eg. a parent or employer.
Please ensure your email system is secure, as Anxiety Mentor cannot be held responsible for others reading any part of your email, even the subject line.
Zoom is a secure (encrypted) video conferencing system and is virtually impossible for anyone to intercept and decrypt the video transmission between two people. However, as with all forms of internet communication, if someone has access to your Zoom login details or has installed a virus on your computer, then it is possible your Zoom transmission can be compromised. Anxiety Mentor is not responsible or liable for compromised Zoom communication between you and your psychotherapist. It is VERY important you keep your Zoom login details secure and private, and routinely check your computer system for viruses and trojans.
All of the above exceptions to confidentiality are extremely rare, but it's important for you to be aware of these limitations of confidentiality under exceptional circumstances.
Cancellation / Rescheduling Policy
We have a 24-hour cancellation policy. This means you may cancel an appointment up until 24 hours prior to your scheduled appointment time. The fee for a cancelled appointment will be refunded (minus a $10.00 PayPal processing fee), which usually takes 4 to 5 days for PayPal to process.
Appointments cannot be cancelled or rescheduled within 24 hours of the scheduled appointment time, and fees paid for the booking are not refunded. A 24-hour cancellation policy is the standard practice for most psychotherapy services.
Under no circumstances will the 24-hour cancellation policy be waived — regardless of illness, technical or any other circumstances that may prevent attendance.
Recording of Zoom psychotherapy sessions
Clients recording Zoom sessions is a violation of our confidentiality agreement and is strictly prohibited. Management reserves the right to suspend all psychotherapy services to any client who records or re-transmits any part of a psychotherapy session.
Limitations of the Service
While the psychotherapists listed on Anxiety Mentor do providing supportive psychotherapy, we are not trained in suicide prevention, so please do not use this service if you are feeling suicidal. Your GP/MD, local hospital or a local crisis hotline can assist if you are feeling suicidal.
1. I understand that I am about to engage in a video therapy session with my provider, Anxiety Mentor
2. I understand that the video conferencing technology will not be the same as an in-person session with a provider due to the fact that I will not be in the same room as my provider. I also understand that, in order to have the best results for this session, I should be in a quiet place with limited interruptions when I start the session.
3. I understand the potential risks to this technology, include interruptions, unauthorized access and technical difficulties. I understand that my provider or I can discontinue the video therapy session if it is felt that the videoconferencing connections are not adequate for the situation.
4. I understand that I can direct questions about this video therapy session at any time to Anxiety Mentor.
5. I understand that this consent will last for the duration of the relationship with Anxiety Mentor, including any additional video therapy sessions I may have; I can withdraw my consent for a video therapy session at any time.
6. I understand that the same confidentiality protections, limits to confidentiality, and rules around my records apply to a video therapy session as they would to an in-person session.
7. I agree to work with Anxiety Mentor to come up with a safety plan, including identifying one or two emergency contacts, in the event of a crisis situation during our sessions.
8. I understand that Anxiety Mentor may decide to terminate video therapy services, if they deem it inappropriate for me to continue therapy through video sessions.
Before making a booking with Anxiety Mentor, I certify:
- That I have read or had this form read and/or had this form explained to me.
- That I fully understand its contents including the risks and benefits of the procedure(s).
- That I have been given opportunity to ask questions and that any questions have been answered to my satisfaction.
- That I agree to participation in a video therapy session(s) with Anxiety Mentor.