Name
Address
Gender (or preferred identity Date of Birth / Age.
Telephone/SMS number (plus permission to send SMS & leave a voice message
Email address
Relationships & Progeny
Occupation & Hobbies
The above information helps me to get to know you and contact you regarding your sessions.
Next of kin
Medical conditions relevant to therapy sought
Prescribed medication
The above information allows me to contact your Dr or next of kin if I was worried you were at risk. If I can I will tell you in advance:
Previous Therapy History
Difficulties & Issues
The above information allows me to formulate a therapy plan tailored to your needs and be able to reflect on previous sessions.
How I Store Your Personal Information:
Paper - written forms including; Contact Sheet / Therapy Information & Agreement Form / GDPR signed agreement - these will be anonymised and kept in a locked filing cabinet in my locked therapy room.
Your Assessment Record / Brief Session Notes will be kept in a separate locked filing cabinet in my locked therapy room/house filing cabinet. The two separate files will be linked by a client code system and these details will be in a password-protected vault on my laptop.
Smartphone - I will store your name and telephone number in my code-protected business smartphone which is exclusively for business purposes text messaging and telephone calls.
Email - your email address and correspondence will be stored in my email account. I will only access my password-protected email account using my password-protected laptop or code-protected tablet.
Website - none of your personal information is stored on the website, other than collecting the contact information if you submit the CONTACT Form and if you choose to use the JOTFORMS to submit your information to book an appointment. This information is processed and passed over via the software.