Our Agreement

All personal information will only be viewed by myself and the client named on the form. Storage of this information will be kept safe in a lockable storage cabinet or under password protection and will be kept for 1 year, for the purpose of the therapy sought and any possible future sessions required.


Confidentiality

As a registered member of the General Hypnotherapy Register (GHR) and EFT International (EFTi) I abide by their Code of Ethics. Matters discussed between us will remain confidential. The exceptions to this confidentiality clause are if:

I believe you or someone else is at risk of serious harm

I hear of harm or abuse to a child

I am ordered by a court of law

I become aware of an act of terrorism

If I believe you are at risk of harming yourself, I will consider contacting your GP, Local Crisis Team and/or emergency contacts. I would make every effort to discuss any concerns I have with you first.

In accordance with best clinical practice, I discuss my work with a supervisor. My supervisor is bound by the same code of confidentiality and ethical framework.

Online sessions will take place using Zoom as this is the most secure platform available, details of Zoom’s security can be found here https://explore.zoom.us/en/trust/security/ A separate online working checklist will be emailed to you.


Data Protection Act

Any personal details I keep are stored securely. Under the terms of the 1998 Data Protection, you must give your consent to such information being made and retained. By signing this agreement, you are giving such permission.

Missed appointments and late arrivals

Therapy sessions are usually once a week, though this may vary by prior agreement. Should you arrive late for a session I will not be able to extend the session beyond our original scheduled ending time.

If you need to cancel a session, 24 hours’ notice is required. One other session date will be offered as an option. On the rare occasion that I am unable to keep our appointment, I will give you as much notice as I can and I will rearrange as soon as possible.


Fees

Therapy fees will be confirmed at consultation and are dependent on treatment required.
All fees are payable on confirmation of appointment time and are non-refundable.





I am responsible for giving full details regarding my health. The above information is complete and accurate. I will notify the therapist of any changes to my health or medication immediately. I understand that my consultation and any subsequent therapy shall remain confidential except in situations where legal statute requires appropriate authorities to be notified. I agree that because people are individual and unique, there can be no guarantees regarding the outcome of any treatment, and I therefore agree that my therapist accepts no liability in this regard. I confirm that I realise that in order to get the best results, I need to work in a collaborative way with the therapist understand that my full co-operation and positive input is required to obtain those best results. I hereby consent to this consultation and any subsequent treatment.

Date:

Client Signature: