• Yurandalli Counselling – Confidentiality Agreement

  • This agreement explains how your information is kept private, when it may be shared, and your rights as a client. Please read each section and provide your consent.

     

    Not an emergency or crisis service

    •Yurandalli is not an emergency or crisis service.

    •If you are in danger or need urgent help, call 000 or go to your nearest hospital emergency department.

    •For crisis support you can contact:

    –Lifeline: 13 11 14

    –Suicide Call Back Service: 1300 659 467

  • Date of birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • About Yurandalli

    •Yurandalli is a professional counselling service in New South Wales.

    •We support people with feelings, thoughts, memories and life stress.

    •We work in a trauma-aware, kind and respectful way.

     

    What is counselling?

    •Counselling is a safe space to talk about what is happening in your life.

    •You choose what you want to talk about.

    •We listen, ask questions and work with you on goals.

    •We cannot promise a specific result (for example, what a court, employer or other person will do), but we will do our best to support you.

     

    Who we support

    •We support all people seeking counselling support

    •We support all communities; First Nations, LGBTIQA+, Disability, Youth, Elderly, and Regional and Remote

    •If we are not the right service for your particular needs we will offer alternatives foryou to explore.

  • Limits of Confidentiality

    Most of what you say in counselling is private (confidential).

    •Your counsellor will not share what you say with others without your okay,except in special situations.

    We may need to share information without your consent if:

    –You are in serious danger, or

    –Someone else is in serious danger, or

    –A child or young person may not be safe, or

    –Reportable Domestic Family and/or Sexual Violence

    –The law says we must (for example, child protection reporting obligations, a court order or serious criminal offense).


    •Your counsellor will explain these limits to you and will try to talk with you before sharing, when it is safe and possible.

    Your counsellor recieves regular supervision and will not disclose your personal information however may speak about content and processes used to ensure best practice. 

  • I understand the limits of confidentiality (when information may be shared without my consent)*

  • Information and Records

    •We collect information like your name, date of birth, contact details and some history.

    •We write notes about sessions so we can remember your story and support you well.

    •We keep your information in secure systems (locked and/or password-protected).

    •We keep records for a set time, as required by law and professional rules. Then we safely destroy or archive them.

    •You can ask to see your information. In some rare cases we may need to limit or delay access for safety or legal reasons.

  • I understand how my information and records are collected, stored and accessed*

  • Appointments, Fees and Cancellation Policy

    •You can ask about fees at any time.

    •If you need to cancel or change an appointment, please tell us at least 48 hours before your session.

    •If you cancel with less than 48 hours’ notice, or do not come to the session, you will be charged the full session fee.

    •We may choose to reduce or waive the fee in serious or unexpected situations (for example, sudden illness, emergency or sorry business).

    •To secure your session, you are expected to pay for the session at least 48 hours before.

     

    ***Victims Counselling Service Clients

    •VCS covers 2 missed appointments, if further appointments are missed your counsellor will discuss if now is the right time to be engaging with the service and will make a referral to alternative resources for when you are ready to re-engage. 

  • I understand the appointments, fees and cancellation policy (including late cancellation fees)*

  • Telehealth Sessions

    •You can have counselling by phone or video if that suits you.

    •Please try to:

    –Be in a quiet, private place

    –Use a device with enough battery and data

    •If the connection fails on our side, we will:

    –Try another way (for example, phone instead of video), or

    –Book another time or arrange a refund/credit if you have paid.

    •If we keep having problems on your side, it may count as a late cancellation or missedappointment. We will talk with you about what is fair.

  • I understand how telehealth sessions (phone or video) work and possible issues*

  • Counselling Tools we might use

    •Sometimes we may offer short questionnaires (for example, NovoPsych) to help track how you are progressing.

    –These are optional.

    –They help with understanding your wellbeing but do not replace clinical judgement or give a formal diagnosis.

     

    •We may use a secure computer program (AI) to help draft session notes.

    –This does not replace your counsellor’s thinking or decision making.

    –Your counsellor checks and edits notes before saving them.

     

    Note: AI is now unavoidable in clinical practice. If you choose to use this service you acknowledge that AI is used and that there are risks. We take your data seriously and implement precautions to protect sensative information. If you have any concerns or questions, please speak with the counsellor. 

     

  • Client Rights

    You have rights as a client. You can ask questions, say no to optional things, ask for a support person or interpreter, access or correct your information, give feedback or complain, stop counselling, or ask for a referral. To access any of these or for feedback, complaints or compliments please contact the counsellor in the first instance. 

  • I understand my rights as a client (including to ask questions, say no to optional things, request support person/interpreter, access/correct information, give feedback/complain, stop counselling or request referral)*
  • Date signed*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date signed (parent/guardian/representative)
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: