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  • DESA Holistic Wellbeing

  • COUNSELLOR/CLIENT BARIATRIC SUPPORT AGREEMENT

    Please read carefully
  • 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.

  • 1. Scope of Services

  • 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.

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  • 2. Counsellor Obligations. 3. Client Responsibilities. 4. Suicide Ideation & Risk. 5. Confidentiality & Records

  • 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.

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  • 6. Fees and Payment

  • Payment Rules/guidelines:

    - Payment due on or before each session unless otherwise arranged

    - Private Health Rebates may be available based on fund and policy

    - 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. Package Description & Fees

    ✨️Bariatric Mindset & Adjustment Counselling Package

    Total Fee: $500

    Includes:

    FREE 15-minute discovery call

    4 × 60-minute counselling sessions:

    2 pre-operative sessions

    2 post-operative sessions

    FREE Bariatric Wellbeing eBook (download link provided after booking)

    Clinical assessments and personalised report

    Telehealth or in-clinic sessions (Saturdays only, 9:30am–4:00pm)

    Payment plans available

    Private health rebates may apply depending on your insurer

    Additional Counselling Sessions

    If ongoing support is requested after the 4-session package:

    Individual counselling sessions are $120 per hour.

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  • 8. Assessment Process

  • 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

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  • 9. Termination of Services

  • 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.

  • 10. Legal Standing & Consent

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

     

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  • Counsellor Name: Desanka (Desa) Ogrizovic

    PACFA Clinical Member No: 28657

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