GDPR Regulations Form LB Wellness Practice
  • PRIVACY STATEMENT IN LINE WITH GENERAL DATA PROTECTION REGULATIONS

    The General Data Protection Regulation (GDPR) is concerned with personal information that I collect, store, and share. Please read this document and sign to indicate that you agree with my procedures.

  • Name

    Address

    Gender (or preferred identity Date of Birth / Age.

    Telephone/SMS number (plus permission to send SMS & leave a voice message

    Email address

    Relationships & Progeny

    Occupation & Hobbies

    The above information helps me to get to know you and contact you regarding your sessions.

    Next of kin

    Medical conditions relevant to therapy sought

    Prescribed medication

    The above information allows me to contact your Dr or next of kin if I was worried you were at risk. If I can I will tell you in advance:

    Previous Therapy History

    Difficulties & Issues

    The above information allows me to formulate a therapy plan tailored to your needs and be able to reflect on previous sessions.

    How I Store Your Personal Information:

    Paper - written forms including; Contact Sheet / Therapy Information & Agreement Form / GDPR signed agreement - these will be anonymised and kept in a locked filing cabinet in my locked therapy room.

    Your Assessment Record / Brief Session Notes will be kept in a separate locked filing cabinet in my locked therapy room/house filing cabinet. The two separate files will be linked by a client code system and these details will be in a password-protected vault on my laptop.

    Smartphone - I will store your name and telephone number in my code-protected business smartphone which is exclusively for business purposes text messaging and telephone calls.

    Email - your email address and correspondence will be stored in my email account. I will only access my password-protected email account using my password-protected laptop or code-protected tablet.

    Website - none of your personal information is stored on the website, other than collecting the contact information if you submit the CONTACT Form and if you choose to use the JOTFORMS to submit your information to book an appointment. This information is processed and passed over via the software.  

  • How long I will store your personal information and how I will dispose of it: I will keep your session notes, contact sheets, assessment and agreements along with your unique code for a period of 8 years (or age 25 if a child client) after our work finishes as required by my membership of the NHC. After this time, I will shred all paperwork and delete your electronic code from the vault. Your email address will be deleted from my email account at the same time. I will keep your name and telephone number on my business phone for a period of 8 years after our work finishes to maintain continuity if you return to me for further advice or treatment. After this time, I will delete your name and telephone number from my business phone. Text messages will be deleted when you finish therapy with me.

    How I may process/share your personal information: Only I will have automatic access to your data and I will never sell this or use it for unethical reasons. It is very unlikely I will share it unless; My notes are subpoenaed by a court of law. If you or anyone you tell me about is at harm or risk of harm I may have to share information. I have regular supervision as required by the National Council for Hypnotherapy (NCH) where I talk about my work, but I will never use your name without your permission. Your name and contact details would be shared with my Therapeutic Executor in the event of my death if you are still in therapy with me and they will contact you to inform you of the situation. If your health is in jeopardy whilst in a session I may share your name and contact information with an emergency healthcare service. If I become aware of your intent to cause harm to another person/organisation (e.g. terrorism) the law may require me to inform an authority without seeking your permission and without your knowledge.

    Your Rights under the GDPR agreement: You have the following rights; The right to be informed what information I hold (this document The right to see the information I hold about you (free of charge for the initial request) subject to timescales within the regulations. The right to rectify any inaccurate or incomplete personal information. The right to withdraw consent to me using your personal information. The right to request your personal information be erased/deleted. The right to data portability. The right to object. The right not to be subject to automated decision making including profiling.

    Other data relating to any sessions held at my clinic or any other clinic has a CCTV camera that records all people that enter the building. This is for therapist safety and crime prevention. Video is recorded through a local independent secure recorder and is maintained by a professional company. Video clips are stored on the system secure recorder, not in the cameras. Video clips are set to automatically delete after a period of time (monthly basis) and will only be viewed if there is a criminal act or footage is requested by police. 

    Do you consent to me using your data as described in the privacy statement above?

  • PRIVACY STATEMENT IN LINE WITH GENERAL DATA PROTECTION REGULATIONS

    This document is signed and dated by both client and therapist to confirm our agreement. Both parties will retain a copy of the signed document.

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