This document is designed to inform you about the management of information that you disclose to the Psychologist. Therapy addresses issues of a highly personal nature and it is important for the success of treatment that you have confidence in the Psychologist's ability to manage your records responsibly. Also provided is a detailed description of fees, and the cancellation policy. As part of providing a psychological service to you, the Psychologist will need to collect and record personal information that is relevant to your current situation. Collection of personal information is a necessary part of assessment and therapy.

Information is gathered as part of the assessment, diagnosis and treatment of a client's condition, and is seen only by the Psychologist. The information is retained in order to document what happens during sessions, and enables the Psychologist to provide a relevant and informed psychological service. All records are held for a minimum of 7 years in accordance with relevant legislation. Records of clients aged 18 years and under are held for a minimum of 7 years after they have reached adulthood (18 years). At no time do other staff have access to information collected during psychology sessions. Administration staff will have access to your general personal and appointment details only.

With the exception of certain specific exceptions described below, you have the absolute right to confidentiality of your information. You are assured that all personal information gathered by the Psychologist during the provision of the psychological service will remain confidential and secure. However, it is important to know there are exceptions in which all Psychologists are mandated (by law) to break confidentiality. This will occur when: 1. The information you have given to your Psychologist is subpoenaed (officially requested) by a Court of Law 2. If the Psychologist should believe that you or another person is at serious risk of serious physical or mental harm 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, school or organisation.

The protection of your status as a current/previous client of this service is paramount, especially as we live in a rural area. As such, the Psychologist will not disclose if you are or have been a client unless under legal obligation to do so (see above), and should the Psychologist encounter you within the community, no acknowledgment of greeting will be made by the Psychologist to you, to protect your privacy.

There may be times where, as part of the assessment and therapy process, it may be helpful for your Psychologist to liaise with other people or agencies that are relevant to your therapy goals (eg. your GP, Medical Specialist, WorkCover, etc If required, your Psychologist will seek your written consent to exchange important information with another professional, service or organisation and the details of what will be shared will be discussed prior.

Please note that if you intend to claim rebates from Medicare or another organisation (such as WorkCover or TAC) then your Psychologist must legally provide summary reports to external agencies regarding your treatment progress. Under the Medicare scheme these reports will normally be sent to your GP or Psychiatrist.

Psychology services are bound by the legal requirements of the National Privacy Principles from the Privacy Amendment (Private Sector) Act 2000. All communications between you and your Psychologist become part of your clinical records, which are stored in your client file. Client files are stored in a secure electronic record system that is accessible only by the Psychologist. A client has a general right of access to all information in their file, unless one of the exceptions to National Privacy Principle 6 applies. These exceptions restrict access where:

• giving access would pose a serious threat to the physical or mental health of any individual
• giving access would jeopardise the privacy of others
• giving access would hinder any law enforcement activities

If you wish to view and / or have a copy of the material recorded in your file then, by law, it is necessary to make the request in writing and send it to the Psychologist at the Medical Centre. Upon receiving your request we will discuss your access options. Please allow 14 days for these arrangements to be made, but we will strive to make your file available earlier if possible.

All consultations are 50 minutes in length. Fees are expected to be paid at the conclusion of each session. A standard 50-minute session is billed at $240.00. If you have been referred by your GP under a Better Access to Mental Health Plan, you are able to claim a rebate of $98.95 from Medicare each session for an initial 6 sessions, and if extended by your GP, a further 4 sessions per calendar year.

If you have Private Health Insurance, you may also be able to claim a rebate.

If, for some reason you need to cancel or postpone the appointment, please give the Psychologist at least 24-hours notice, otherwise you will be charged a cancellation fee of $240.00 or 100% of the session cost that will be billed. Please note that Medicare or health insurance rebates are not applicable to cancellation fees.

The Psychologist will be available for short phone calls outside of psychological sessions, however a crisis service or counselling over the telephone is not provided. In the event of a mental health crisis, the local Mental Health Service, your GP, or Emergency Services should be contacted, or attend to your nearest Hospital Emergency centre. The Psychologist will ensure that you have access to the details of these services, and also any other such supports (such as Lifeline).

, have read and understood the above Consent Form.

I agree to these conditions for the psychological service provided at Stawell Medical Centre.

Please Note: If, after reading this page you are unsure of what is written, please discuss it with the Psychologist before signing.