This document formalises the counselling and coaching agreement between Desanka (“Desa”) Ogrizovic, PACFA Clinical Member, and the client.

Desa provides specialised bariatric counselling services designed to support clients emotionally before and after bariatric surgery. These services are offered in collaboration with Better Life Surgery and Dr Mo Atalla, to ensure a holistic, patient-centred model of care.

By completing this form, you acknowledge:
your understanding of the counselling process
the scope of bariatric psychological support
confidentiality and privacy policies
your rights and responsibilities as a client
consent to engage in counselling services.

It outlines the responsibilities, procedures, packages, and pricing for therapeutic and coaching services before and after bariatric surgery, to be signed digitally via Jotform.

Desanka (Desa) Ogrizovic offers integrated therapeutic support to clients pursuing bariatric surgery or weightloss transformation. This includes evidence-based counselling for trauma, emotional regulation, body image, and empowerment coaching.

2. Counsellor Obligations:

- Maintain ethical standards under PACFA Code of Ethics

- Provide trauma-informed, person-centred, and confidential care Refer to specialists as needed, and ensure duty of care in all circumstances

3. Client Responsibilities:

- Attend scheduled sessions or give 24 hours' notice to avoid fees

- Actively participate in discussions and tools provided

- Engage in assigned assessments and self-reflection exercises

4. Suicide Ideation and Risk:

If suicide ideation or serious risk to self or others is disclosed, Desanka (Desa) Ogrizovic is legally obligated to take appropriate action which may include emergency referral, notifying GP, or contacting crisis services.

5. Confidentiality and Records:

All client information is confidential and handled according to Australian privacy laws. Files are securely stored for 7 years.

Payment Rules/guidelines:

- Payment due on or before each session unless otherwise arranged

- Late cancellations (under 24 hours) will incur a full session fee

-Payment Plan Options may be available*

*Payment plans must be agreed upon in writing prior to service commencement. A deposit may be required. Missed or late payments may result in the suspension of sessions until the account is brought up to date.

7. Service Description & Fees

✨️Bariatric Mindset & Adjustment Counselling:

Includes:

1 × 60-minute counselling session/ pre-operative assessment session (50 minutes plus 10 minutes case summary paperwork):

2 post-operative sessions (25 minutes each)

FREE Bariatric Wellbeing eBooks (download link provided after booking)

Clinical assessments and personalised report

Telehealth or in-clinic sessions (Saturdays only, 10am–3:00pm VIC time.)

Payment plans available**

Additional Counselling Sessions

If ongoing support is requested after:

Individual counselling sessions are $120 per hour after the 2 post operative shorter sessions which are optional if you want ongoing support

The initial assessment involves:

- Psychosocial screening

- Exploration of mental health history, eating patterns, body image

- Identification of coping mechanisms and emotional readiness for surgery

- Setting achievable and empowering personal goals

Either party may discontinue counselling at any time. A final session is recommended for therapeutic closure.

If a package has been paid for in advance, no refunds will be issued for unused sessions.

However, any remaining sessions may be used within 6 months of the original agreement date, subject to availability.

This agreement is subject to Australian laws and PACFA standards. The client agrees to the terms stated above.

 

Counsellor Name: Desanka (Desa) Ogrizovic

PACFA Clinical Member No: 28657