Client Consent Form

Your Psychologist will need to collect and record personal and sensitive information relevant to your current situation. This information is necessary to provide accurate assessment, diagnosis, and evidence-based treatment.

By engaging in psychological services, you consent to the collection, use, and secure storage of your information in accordance with the Privacy Act 1988 (Cth) and the Australian Psychological Society (APS) Code of Ethics.

You have the right to access your information, request corrections, and discuss any concerns about its use at any time.

Privacy, Confidentiality, and Use of Technology

All personal information you provide is treated as confidential and securely stored. Your information will not be shared without your written consent, except in the following circumstances:

• If there is a serious and imminent risk to your safety or the safety of another person.

• If your Psychologist is legally required to disclose information (e.g., through a subpoena or court order).

• If disclosure is required or authorised by law.

• When third-party funding applies (such as Medicare and Workers' Compensation), limited and relevant information will be shared with your referring medical practitioner or insurer to support your treatment plan.

Use of Artificial Intelligence (AI) Technology

To enhance the quality and efficiency of services, AI technology may be used in limited ways, such as:

• Assisting with administrative tasks (e.g., appointment reminders, document drafting).

• Supporting clinical documentation, such as summarising session notes or generating reports.

Important notes regarding AI use:

• AI tools used comply with Australian privacy laws, and measures are in place to ensure the security and confidentiality of your information.

• AI technology does not replace professional judgment. Your psychologist reviews and verifies all outputs generated by AI systems.

• Sensitive personal information is de-identified or anonymised where possible before being processed by AI technologies.

Professional Boundaries

In line with the APS Code of Ethics, Psychologists do not engage in dual relationships with clients, including accepting social media connection requests. Any such requests will be respectfully declined to maintain clear professional boundaries.

Fees

The following fees apply for services provided:

• Face-to-Face and Telehealth Sessions :

  • $220 per hour.

  • $250 per hour after 4pm and on Saturdays.

• Short Sessions (30 minutes) :

  • $140.

  • $170 after 4pm and on Saturdays.

• Court Reports or Other Formal Reports :

  • $2,850.

  • An additional $500 applies for urgent reports required within short timeframes.

• Letters (for work, university, etc.) :

  • From $150 (depending on complexity and time involved).

A receipt will be provided for you to claim a Medicare rebate if you have a valid Mental Health Care Plan.

Cancellations

If you are unable to attend your appointment, please provide as much notice as possible.

• Cancellations with less than 3 hours' notice will incur a fee:

  • $220 for a 1-hour session.

  • $140 for a 30-minute session.

Acknowledgement

By attending your first session, you confirm that you have read and understood this information regarding consent, privacy, fees, cancellation policy, and the use of technology, including AI. You may withdraw your consent at any time, although this may affect the ability of your Psychologist to provide ongoing services.