Consent forms hold important information about how we obtain, hold, protect and share your information. It takes a lot to run a health clinic and there are lots of things we think about ethically, as well as requirements we have legally.
At Mind Mode we have a bunch of programs we use, as well as administration staff, finance staff, technical staff and our clinicians! There is a lot of us that allows the clinic to run smoothly, and we try to make sure that everybody only has access to the information that they need in order to be able to do their job, which at the end of the day, is helping you in your development of positive mental and physical health.
Providing a consent form and requiring you to read it is an important step in good ethical practice so we can get you onto the next step in your journey of wellbeing. We want to be as open and transparent as possible, so you can trust us with your health, and we encourage any questions or queries into our different policies or procedures.
All psychologists are legally required to be registered in Australia with the Psychology Board of Australia and AHPRA. Mind Mode also requires our counsellors to be registered with PACFA, which means your clinician is registered with a body that maintains safeguards and checks to ensure that your clinician is properly trained and ensures that you receive high quality, ethical service.
As a client of a Mind Mode clinician, you have a right to expect that:
You will be treated with respect at all times
Your cultural background and language tradition will be respected
You will be given a clear explanation of the services you will receive
You will be asked to give your consent for any service provided by your psychologist prior to the service commencing and as it progresses
You will receive an explanation about the confidentiality of the service and the exceptional situations where your confidentiality may not be protected
You will receive a clear statement about fees for your psychologist’s services
You will receive skilled and professional services from your psychologist
There will be clear goals that you and your psychologist are working toward
You can ask any questions about the service you are receiving.
The Psychologist will be willing to receive feedback and requests for changes in approaches and methods
If you have any concerns about the above matters, discuss them with your psychologist. If you have concerns about the conduct of your psychologist, please contact Mind Mode through the email email@example.com and your concerns will be addressed as a priority. You may also call the Psychology Board of Australia on 1300 419 495.
Psychology and counselling are human services that requires the provision of a safe space. We acknowledge that with each right we have we also have responsibilities, and these responsibilities are in place to ensure the safety of yourself, our staff, other client’s and others that you may come into contact within your journey with us.
As a client of a Mind Mode clinician, you will be expected to uphold the following responsibilities.
Respect other people’s rights to a safe, secure and comfortable environment.
Treat other clients, staff and volunteers with fairness, honesty and respect.
Respect other people’s rights to privacy and confidentiality, this extends beyond the waiting room.
Understand your own rights to confidentiality and the restrictions/exceptions outlined in your confidentiality form. If you have queries regarding this, it is your responsibility to seek clarification and to act in a respectful manner if your practitioner is required to enact their legal obligations.
Actively participate in your treatment, discussing and agreeing to a treatment plan with your psychologist/counsellor and communicating to them when you feel that something is not working, or you would like to request a change.
Attend sessions to the best of their ability in a ‘fit state’, without being inhibited by substances or alcohol.
Not record sessions in any way without the permission of the psychologist.
Utilise material and information provided for its intended purposes only.
(This includes reports and support letters, which should be provided only to the intended recipient in the agreed upon context, as well as any copywrite material produced by your practitioner).
Be aware of your financial obligations, including being aware of the cancellation policy.
(Mind Mode is aware that financial stress can impact on your well-being and attendance to treatment. Our fees are set below the Standard Fee Schedule of the Australian Psychological Society in an effort to remain available to clients with financial concerns. Further exceptions can be made if you are living in a refuge, or are with Domestic Violence services, please speak to your psychologist if this is the case.)
As part of providing psychological services to you, your psychologist needs to collect and record personal information from you that is relevant to your situation, such as your name, contact information, medical history and other relevant information. This collection of personal information will be a necessary part of the psychological assessment and treatment that is conducted.
Your personal information is gathered as part of your assessment and treatment, is kept securely and, in the interests of your privacy, used only by your psychologist and the authorised personnel of the practice (e.g. administration staff). Your personal information is retained in order to document what happens during sessions, and enables the psychologist to provide a relevant and informed psychological service to you. When referred to treatment under Medicare it is part of legislation the reports of progress be provided to the treating GP. If you have not been referred by your GP it is still recommended that you provide permission to contact and share information with them to ensure continuity of care and holistic treatment.
At any stage you are entitled to access your personal information kept on file, subject to exceptions in the relevant legislation. Your psychologist may discuss with you different forms of access.
All personal information gathered by the psychologist during the provision of the psychological service will remain confidential except when:
1. It is subpoenaed by a court; or
2. Failure to disclose the information would in the reasonable belief of your psychologist place you or another person at serious risk to life, health or safety; or
3. Your prior approval has been obtained to:
a) Provide a written report to another professional or agency. e.g., a GP or a lawyer; or
b) Discuss the material with another person, eg. a parent, employer or health provider; or
c) Disclose the information in another way; or
d) You would reasonably expect your personal information to be disclosed 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; or
e) Disclosure is otherwise required or authorised by law.
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.
You understand that attending sessions with your clinician has risks and benefits associated with it and each individual will have different reactions to therapy. In the short term, therapy can sometimes bring about unpleasant thoughts and feelings but can have the effect of reducing these symptoms in the long term. If you are experiencing distress attending therapy, please inform your clinician to discuss ways of managing and reducing this distress.
Additionally, each individual will have a different personal timeline for therapy, and we cannot guarantee whether therapy will be right for you and how long it will take.
Mind Mode values honesty and transparency and will endeavour to take reasonable steps to ensure clients are aware of the costs of sessions prior to their delivery.
At times the fees with Mind Mode or/and their clinicians may change. Mind Mode will make all reasonable attempts to provide information regarding any intended changes or increases within a reasonable timeframe.
Mind Mode acknowledges the need for some clients to attend sessions outside of normal business hours, and a number of clinicians have chosen to provide these sessions for the convenience of those who need them. Out of hours sessions will attract a 10% surcharge to cover the costs of running these sessions outside of normal business hours, including the time taken after the session to complete tasks created by the session.
Mind Mode has a number of ways you can make payment. Unfortunately, due to the fees charged by the eftpos providers, a surcharge will be charged on credit and debit card payments.
In response to these fees Mind Mode also provides payment methods that do not charge a fee.
The preferred method of payment is via PayID (firstname.lastname@example.org), we can also provide you with bank details for a transfer, or we can also accept cash.
WE REQUIRE 48 HOURS NOTICE FOR ANY APPOINTMENT CHANGES, CANCELLATIONS AND RE-BOOKINGS.
Our cancellation policy ensures that all clients have a chance to see their psychologist at their earliest convenience.
We understand that circumstances may arise that require you to cancel your appointment, but providing adequate notice allows other clients an opportunity to fill your spot.
If you need to cancel or postpone your appointment, please provide *a minimum of 48 hours notice*. Failure to do so will result in a cancellation fee of 50% of the scheduled session fee. If less than 24 hours notice is given, or you fail to attend a schedule appointment, you will incur the full cost of the scheduled session. This policy refers to all clients. Where third parties responsible for our fees do not pay for late cancellations or failure to attend a scheduled appointment, you may be required to personally pay.
Reminder texts and emails are sent prior to the appointment however, it is your responsibility to ensure you have responded in the appropriate time frame.
In order to communicate with you we use email, text and phone calls. From time to time our clinicians may contact you via email to provide resources, updates or other relevant information. Our clinicians will also occasionally text you through PowerDiary to confirm appointments or provide updates. These communications are attached to your clinical file.
If you need to change an appointment or discuss something with your clinician, the best way to contact us is through our administration team. Please do not contact Mind Mode via Facebook, Instagram or any other social media account as they are not designed for this purpose, and you may be compromising your confidentiality.
Our standard hours of communication are between 9am and 5pm. If you contact us outside of these hours there will be a delay in getting back to you.
Where appropriate the service may be provided by telephone or videoconferencing. You are responsible for the costs associated with setting up the technology needed so you can access telehealth services. Mind Mode and your practitioner will be responsible for the cost of the call to you and the cost associated with the platform used to conduct telehealth services.
To access telehealth consultations, you will need access to a quiet, private space; and the appropriate device, i.e. smartphone, laptop, iPad, computer, with a camera, microphone and speakers; and a reliable broadband internet connection.
By signing this consent, you are stating that you understand and agree not to record, either visual or audio information, whilst conducting a telehealth session, unless discussed and agreed upon with your psychologist. Your psychologist understands and agrees to the same.
The privacy of any form of communication via the internet is potentially vulnerable and limited by the security of the technology used. To support the security of your personal information this practice uses Power Diary which is compliant with the Australian standards for online security and encryption.
LIMITATIONS OF TELEHEALTH
A telehealth consultation may be subject to limitations such as an unstable network connection which may affect the quality of the psychology session. In addition, there may be some services for which telehealth is not appropriate or effective. Your psychologist will consider and discuss with you the appropriateness of ongoing telehealth sessions.
If technical issues interfere with the session to the point that we cannot continue, your psychologist will call you on the phone to discuss your options, which may include continuing the session by phone.
The cost of a consultation (approximately “50” minutes) may vary depending on your practitioner, as Mind Mode is a mixed billing practice. Fees are shown on the Mind Mode website (Our Current Fees (mindmode.com.au) and can be discussed with reception. This fee is payable prior to your session, through card, cash or online payment. Your psychologist will discuss with you your eligibility for Medicare or other compensable funding.
Mind Mode Psychological Services
Wollongong | Campbelltown | Online
Level 2, Suite 1/310 Crown Street, Wollongong NSW 2500 | Phone: (02) 4288 4667
11b Chamberlain Street, Campbelltown, NSW, 2560 | Phone (02) 7228 8388
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