As part of providing a quality service for your child, Melbourne Child Development will need to collect and store information about your child. In order to thoroughly assess, diagnose and provide therapy, we will need to also collect some personal information from you and from other professionals involved in your child’s care. This information and information concerning assessments, reports, diagnosis and treatment of your child will also be used for:
I, the undersigned, have read the above information and understand and accept the reasons for collecting the information and the ways in which the information may be used.
I understand that it is my choice as to what information I provide in relation to the child and that withholding or falsifying information might act against the best interests of the child in the assessment and progress of the therapy.
I am aware that if, in exceptional circumstances, access to information from the child’s Speech Pathology file is denied for legitimate purposes, that the reasons for this and possible remedies will be explained to me.
I understand that this Practice must obtain additional consent if the information collected is to be used in any way other than that outlined above.
I am aware that I may rescind this permission at any time either verbally or in writing.
If you cannot attend a session, please provide a minimum of two business days notice. If less than two business days notice is provided, a fee of 50% of the cost of the session will be charged. Cancellation fees are usually the responsibility of the parent/carer as most funding and rebate programs do not cover these.
PROGRAM TERMS & CONDITIONS
*Should Melbourne Child Development be unable to offer you a place in the More Than Words Program, any administration fees paid will be refunded.
This fee is for setting up the file and co-ordinating the Program.
This administration fee will be deducted from the cost of the Pre-Program Consultation. This administration fee is not refundable unless Melbourne Child Development are unable to offer you a place in the Program.
Please Note: If you do not understand any of the information that is outlined in this document or if you have further questions, please do not hesitate to discuss these with the Practice Principal Robyn Stephen.