New Client Intake Information and Consent Form

These questions are optional and are asked to help provide culturally safe and affirming care.

Session Locations

Counselling sessions are provided online, via video or phone call or in person.

In person sessions are available at

• 8/10 Clinch Avenue Preston, Victoria
• 6/160 Edward Street Brunswick, Victoria

Please say if you are able to attend one or both venues easily. Both are ground floor, space for a wheelchair/mobility aid and Preston has an accessible toilet. 

Parking

• Preston - available next door 90 minutes free Woolworths car park or in the street opposite the building entrance 2 hours free
• Brunswick - 1 hour around lygon street but there is free parking on Ewing Street a couple of blocks away

Attending Sessions

To ensure privacy, safety and therapeutic effectiveness:

• Sessions take place between you and the Counsellor Caroline Spiers
• If you arrive unable to participate safely due to intoxication or another reason as determined by the Counsellor, the session may be cancelled and the cancellation policy may apply.
• If a session has been agreed to occur via phone or video call, you must be in a private, confidential location. If you are driving, or in a public place (such as a café), where others may hear you or otherwise unable to participate privately and safely, the session will be ended and rescheduled.

Cancellation Policy

Where possible, provide at least 24 hours notice if you need to cancel or reschedule.

Appointments cancelled with less than 24 hours' notice, or missed without notice, will incur 100% of the session fee, except in exceptional circumstances at Counsellor's discretion.

Fees & Invoicing

Invoices and payment administration is managed by Jacob @ Bear Bookkeeping Solutions

By attending therapy sessions with the Counsellor you consent to your contact details and invoice information being shared with Bear Bookkeeping solely for the purpose of managing appointments, invoicing and payments.

Fees 2026 are:

$200 per hour session individual sessions

$300 per hour session couples sessions

 

I operate a sliding scale of fees for those experiencing challenges with finances

Confidentiality

Your privacy is protected.

Everything discussed during counselling is confidential except where disclosure is required or permitted by law or where there is a serious and imminent risk of harm.

Confidentiality may be breached if:

• The Counsellor reasonably believes there is an imminent and serious risk that you may cause significant harm to yourself or another person within 2 hours of a session ending
• disclosure is required by law (for example, mandatory reporting obligations or a court order); or
• you provide written consent (email) for information to be shared.

Where it is safe and practical to do so, I will discuss any proposed disclosure with you before contacting emergency services or another appropriate person.