
CONSENT FORMS & POLICIES
Psychological Service
Welcome to At Home Psychology, where you will be attending psychological therapy with Phoebe Rogers, Clinical Psychologist. In this consent form information regarding the collection of personal information, confidentiality, fees, and cancellation policy will be outlined. If there are any questions, Phoebe will be glad to assist.
Personal information
As part of providing a psychological service, Phoebe will collect personal information about you. This is a necessary part of assessment and treatment and used for your care.
Access and confidentiality
All information is kept securely and can only be accessed by Phoebe. Phoebe is required to communicate with your GP in writing if you were referred under a mental health care plan or similar. You may access the information in your file upon request unless legislation states otherwise. Phoebe may discuss different possible forms of access with you.
Disclosure of personal information
All personal information gathered by Phoebe during the provision of the psychological service will remain confidential except when:
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It is subpoenaed by a court, or disclosure is otherwise required or authorised by law; or
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Failure to disclose the information would in the reasonable belief of Phoebe place you or another person at serious risk to life, health, or safety; or
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your prior approval has been obtained to:
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provide a written report to another professional or agency. e.g., a GP or a lawyer; or
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discuss the material with another person; or
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disclose the information in another way; or
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disclose to another professional or agency (e.g., your GP) and disclosure of your personal information to that third party is for a purpose which is directly related to the primary purpose for which your personal information was collected.
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Your personal information is not disclosed to overseas recipients, unless you consent, or such disclosure is otherwise required by law. Your personal information will not be used, sold, rented, or disclosed for any other purpose.
Fees
A standard consultation is 50 minutes and fees are as follows:
$230 for an individual (adolescent or adult) therapy consultation
$260 for a couples or family therapy consultation
$180 for clinical supervision
Fees are payable via cash, card, or direct deposit only, and are due at the end of the session. Receipts will be issued upon receipt of payment.
Cancellation policy
If you need to cancel or reschedule an appointment, please provide at least 48 business hours’ notice (Monday – Friday, excluding public holidays and weekends) so that the session can be offered to another client.
Cancellations or rescheduling with less than 48 hours’ notice will incur the full session fee.
If you are unwell or experiencing cold or flu-like symptoms, please notify Phoebe as promptly as possible. Sessions may be moved to phone or online to ensure safety for all.
Deposit and Cancellation of Initial Appointments
A 50% deposit is required to secure all initial appointments. This deposit is applied toward the total session fee.
If you choose not to proceed with your booking, your deposit will be refunded where at least 48 hours’ notice is provided prior to your scheduled appointment time.
Where less than 48 hours’ notice is given, the deposit may be retained to cover administrative and booking costs, except where required by law.
This is separate from the 48-hour booking hold period, during which your appointment must be confirmed through completed intake forms and deposit payment.
