The Counselling Wollongong Studio

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Counselling Agreement and Confidentiality

Version: 30 October 2026.

RCS-Health trading as The Counselling Wollongong Studio. ABN 61 529 395 719. Isaac Bailey, BASS-C, MASS-C, Clinical Counsellor and Supervisor with PACFA.

This agreement explains counselling arrangements, confidentiality and information handling. Please read it and ask about anything unclear before agreeing. Consent is an ongoing conversation, not only a signature.

Couples, families and young people may need additional discussions about consent and privacy.

Collection notice: RCS-Health trading as The Counselling Wollongong Studio collects the identity, consent, representative and contact information in this form to clarify counselling arrangements, record your decisions, communicate safely, and meet applicable clinical and legal responsibilities. Jotform hosts this intake and consent-form process. The information-handling purposes, providers and confidentiality limits are described below. You may request access or correction and raise a privacy concern. If necessary details or consent cannot be provided, the counsellor will discuss whether and how the service can proceed; do not enter unsafe information.

1. Counselling and choice

Counselling offers a respectful setting to explore concerns and work toward agreed goals. You choose what to discuss. Your counsellor considers suitability and will discuss alternatives where needed. No particular clinical, relationship, court, employment or other outcome is guaranteed. You can ask questions, discuss concerns, pause or end counselling. This form is not an emergency service. If there is immediate danger, call 000.

2. Confidentiality and supervision

Information shared in counselling is treated confidentially. Relevant information may be disclosed with your consent or where disclosure is required or otherwise permitted by law. This can include applicable child-protection obligations, serious safety risks and lawful court requirements. A disclosure of domestic, family or sexual violence does not automatically mean all information is reported to police. Where safe, lawful and practicable, your counsellor will discuss the reason and scope of disclosure with you. Information disclosed should be limited to what is relevant to its purpose.

Your counsellor uses professional supervision to support safe, effective practice. Information is de-identified where practicable and handled under appropriate confidentiality arrangements. Identifiable disclosure requires an appropriate lawful basis.

3. Couples and families

Before joint work, we will agree who receives the service, its purpose, how individual and joint communications are handled, who can access which records and what happens if a participant withdraws. Please ask before sending information you expect to be kept from another participant. Information from separate conversations is not automatically promised to be either shared or concealed. Safety, suitability and conflicts will be reviewed throughout the work. Each participating adult provides their own consent.

4. Children and representatives

A young person’s understanding, capacity to consent, views, safety and relevant legal arrangements are considered individually. Where a parent, guardian or representative is involved, the counsellor will discuss their authority and role, the young person’s privacy and what may be shared. A parent or carer does not automatically receive unrestricted access to everything a young person says or all records. Relevant court or guardianship arrangements should be raised safely before care.

Children listed for family context on an intake form do not automatically become clients. Consent and authority must be discussed separately for any proposed child participant. Family therapy is offered for participants aged 11 and over, subject to suitability; listing a younger child does not confirm service eligibility.

5. Records and privacy

The practice collects information needed for enquiries, suitability, counselling, appointments, payments, clinical records and applicable legal and professional responsibilities. Jotform hosts the practice’s intake and consent forms. Halaxy and Xero support billing and payment administration, Zoom online sessions, NovoNote transcription and clinical notes and Ai is generally embeded into Microsoft software, OpenAi is used to formulate draft counselling plans, psychoeducation and other counselling materials. Learning mode is turned off for OpenAi usage. Each service processes information relevant to its function; this does not mean every provider receives your full clinical file. Some providers or subprocessors may process information outside Australia.

You may request access to or correction of your information and raise a privacy concern. Lawful access restrictions and available review options will be explained. Clinical records are retained and disposed of under applicable requirements and the practice’s approved procedures. Transcript deletion is separate from clinical-note retention.

6. NovoNote and AI-assisted notes

NovoNote listens to sessions, transcribes session content and generates draft notes. Your counsellor reviews and edits the notes. The transcripts are deleted after notes are finalised. The resulting clinical notes are retained as part of your clinical record. Relevant processing, audio handling, recipients and overseas arrangements are explained in privacy information. If you have any concerns or questions about the use of Ai, you can contact the practive via the online enquiry form.

Questionnaires, including NovoPsych, may help understanding and progress monitoring; they do not replace clinical judgment or alone establish diagnosis. Questionnaire preferences are separate from NovoNote consent.

7. Fees and appointments

All sessions are 50 minutes. Fees in Australian dollars:

Before 5 pm: individual $140; couples $155; family $185.
From 5 pm: individual $150; couples $165; family $195.

The same rates apply in Wollongong, Dapto and Zoom. No rebates are available.

Please give at least 48 hours’ notice to cancel or change an appointment. Less notice or non-attendance incurs the full fee, subject to agreed exceptions and applicable rights. Reduction or waiver may be considered for serious or unexpected circumstances. This agreement does not authorise automatic charging. Any approved payment arrangements are handled separately. Do not enter card numbers, expiry dates or security codes in this form.

8. Online sessions

Online sessions use Zoom. Choose a private location and stable connection where possible; tell your counsellor if privacy is difficult. Discuss current location, urgent safety needs and a connection-loss plan at each session. Routine telephone counselling is not offered; any safety or reconnection call must be agreed separately.

9. Your rights and complaints

You can ask questions, seek explanation, discuss access or communication needs, ask about a support person or interpreter, access or correct information, provide feedback or complain, and discuss ending counselling or referral. Let the counsellor know if communication or another person’s involvement is unsafe. You are not required to complain to the counsellor before exercising independent complaint rights.

Practice complaints form: Submit a complaint to the practice. A proprietary form is not intended to remove access or correction rights.

10. Before signing

Please identify any questions or arrangements needing discussion. A signature does not waive legal rights or authorise unrelated disclosures. Each adult signs their own agreement. Representative authority and young-person consent or assent must be considered individually.

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Your full name* This field is required.

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Your date of birth (DD/MM/YYYY)* This field is required.

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Your phone Number* This field is required.

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Questions, access needs or arrangements to discuss before agreeing (optional)You may write “discuss privately”. Do not include detailed sensitive information or unsafe contact details.

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Counselling and choice (section 1)* This field is required.

I understand this section

I would like this explained before agreeing

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Confidentiality, supervision and lawful limits (section 2)* This field is required.

I understand this section

I would like this explained before agreeing

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Couples, families, children and representative arrangements (sections 3–4)* This field is required.

I understand this section

I would like this explained before agreeing

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Records, privacy, rights and complaints (sections 5 and 9)* This field is required.

I understand this section

I would like this explained before agreeing

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Fees, cancellation and no rebates (section 7)* This field is required.

I understand this section

I would like this explained before agreeing

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NovoNote listening, transcription, AI-assisted clinical notes and OpenAi use (section 6)* This field is required.

I understand and consent to the described Ai use

I need more information before deciding

I do not consent — I need to discuss

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Online-session arrangements (section 8)* This field is required.

I understand this section

I would like this explained before agreeing

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Optional questionnaires, including NovoPsych* This field is required.This preference is separate from NovoNote use. Questionnaires do not replace clinical judgment.

consent to relevant questionnaires

Prefer not to use questionnaires

I would like more information

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Your agreement decision* This field is required.

I agree

I need discussion before agreeing

I do not agree

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Participant signature — only after agreement is settledLeave blank if you need discussion or do not agree. For a young person, the counsellor will discuss capacity, consent and assent; do not sign for another adult.

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Date signed (DD/MM/YYYY) — participant and/or representativeEnter the actual signing date. If signatures occur on different dates, identify each signer and their date. Leave blank while seeking discussion.