Access to Client Information
At any stage, you as a client are entitled to access to the information about you kept on file, subject to exceptions as stated in the Privacy Amendment Act 2000 (National Privacy Principal 6). This means that your request must be serious in nature, i.e., “the request must not be frivolous or vexatious”. Upon request, the appropriate form of access may be discussed.
Confidentiality
Please note that routine practice requires written and at times verbal communication with your referring doctor. If you are referred under a Mental Health Care Plan through Medicare, written communication is mandatory following six Medicare-funded sessions and upon completion of the psychological service.
Fees, Length & Cancellation
Fees are $350 for a standard session.
The standard length of session is about 50 minutes and the usual Medicare rebate applies. However, if session is shorter (for example, if you are more than five minutes late) a different item number must be billed and a less rebate is obtainable.
If for some reasons you need to cancel or postpone the appointment, please provide at least 48 hours notice. Lack of notice will incur a cancelation fee. If you cancel with less than 48 hours notice, a fee equal to half of the cost of the session may apply. If you cancel with less than 24 hours notice, a full fee equal to the cost of the session may apply. Please note that cancellation fees are NOT covered by Medicare or private insurance.
I, First Name Last Name, have read and understood the above information and Consent Form. I agree to these conditions and provide consent for the release and exchange of clinical information with my referral doctor.
Address: 1718 Colonial Hills Dr, Southaven, MS, 38671
Website: www.samplepsychologyclinic.com
Email: contact@psychologyclinic.com
Phone: (123) 456-7891