
CREATE PSYCHOLOGY NQ
P.O Box 140 Thuringowa Central, 4817
Phone: 0408 515 716
hello@createpsychologynq.com
CLIENT CONSENT FORM
When you engage with Create Psychology NQ, it’s our duty to make sure you understand and agree with our terms on consent, privacy, and confidentiality. This document outlines how we manage your sensitive and personal information. If you have questions, please consult your psychologist.
CONFIDENTIALITY
For effective psychological services, we collect and record personal information pertinent to your situation. This information is integral for assessment and treatment planning. It’s securely stored in electronic form using secure third-party client management software, both within Australia and overseas. Access is limited to authorised personnel. Information gathered is used for monitoring progress and tailoring your treatment.
Your information remains confidential except under these conditions:
- Immediate threat to life, health, or safety.
- Child endangerment.
- With your prior consent for:
o Reports to professionals or agencies, e.g., a GP or lawyer.
o Discussions with third parties, e.g., a parent or employer. - Court-ordered subpoenas.
- Legal requirements, including criminal disclosure.
Your data will not be used or disclosed for unrelated purposes.
CONSEQUENCE OF NON-DISCLOSURE
Failure to provide information per this policy may prevent us from offering services. You may opt for anonymity or pseudonymity unless impractical or legally prohibited. In such cases, payment is due at the time of appointment.
EXCHANGE OF CLIENT INFORMATION
Sometimes, it’s beneficial to share your data with third parties relevant to your therapy (e.g., GP, specialists). If claiming rebates from Medicare or similar, summary reports will be sent to external agencies. Signing this form consents to such sharing for quality of care.
ACCESSING TO INFORMATION
You have the right to access your stored data, subject to legislative exceptions detailed in our Privacy Policy.
COUNSELLING SERVICES AND FEES
Sessions typically last 45-50 minutes. Medicare, private healthcare or other rebates may apply.
CANCELLATION POLICY
If you cannot attend a scheduled appointment, please provide at least 24 hours notice for cancellations or reschedules to avoid a cancellation fee.