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 range of services, a number of different programs and applications, as well as administration staff, finance staff, technical staff and our clinicians! 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 achieve your therapeutic goals.
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 your information, and we encourage any questions or queries into our different policies or procedures.
If you have any questions or would like to discuss the following information, please don't hesitate to contact us or speak to your clinician.
This consent form covers consent for both Mind Mode and your clinician who may trade as an individual entity.
Please be aware that most clinicians working under the Mind Mode brand are sole traders or individual entities running their own business.
Mind Mode acts as a facilitative, managerial, and administrative service for these individual entities which is why many of the forms and resources provided will reference Mind Mode but also be referring to your clinicians individual business entity. This is a common way for Allied Health Private practices to operate.
Please be aware that any forms or agreements you are asked to sign, including this one, act as a combined document for your convenience however, your clinician and the individual entity they run are ultimately responsible for your care and the maintenance of your information.
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, and Dietitians be registered through Dietitians Australia 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:
NOTE:
If you have any concerns about the above matters, please discuss them first with your clinician. If you have concerns about the conduct of your clinician, please contact Mind Mode Management through the email practicemanager@mindmode.com.au and your concerns will be addressed as a priority. You may also call any of the above mentioned bodies depending on the registration of your clinician.
Psychology, counselling and dietetics are human services that require 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 with during your journey with us.
As a client of a Mind Mode clinician, you will be expected to uphold the following responsibilities:
As part of providing clinical services to you, your clinician 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 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 clinician 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 clinician to provide a relevant and informed clinical 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, subject to exceptions in the relevant legislation. Your psychologist/counsellor/clinician may discuss with you different forms of access to this information.
All personal information gathered by the psychologist/counsellor/clinician during the provision of the psychological service will remain confidential except when:
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 (pay@mindmode.com.au), 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 clinician 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. In out of office times our appointment reminder text system and email address can still receive communication to indicate an appointment is cancelled. 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 set to be sent prior to the appointment for your convenience however, it is your responsibility to ensure you manage your own appointments 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 Zanda (previously known as PowerDiary) to confirm appointments or provide updates. Please be aware that all communications done through the Zanda program, including all texts are viewed by the Mind Mode admin team and that 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 regularly monitored and are not designed for this purpose, you may not be answered promptly, and you may be compromising your confidentiality.
If you wish to communicate directly with your clinician without the admin team involvement, you will need to first discuss this with your clinician as to their preferred secure method.
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; an appropriate device, i.e. smartphone, laptop, iPad, computer, with a camera, microphone and speakers; and a reliable broadband internet connection. If others are within the same room or within listening distance, you are required to disclose this to the clinician.
By consenting to this policy, 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/counsellor/clinician. Your clinician 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 Zanda (previously known as Power Diary) in conjunction with Doxyme or Zoom for telehealth sessions which are both compliant with the Australian standards for online security and encryption.
LIMITATIONS TO 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 clinician 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 clinician will call you on the phone to discuss your options, which may include continuing the session by phone.
Based on client needs there may be some clinicians that offer Out of Office as a part of treatment. This will be collaboratively discussed between yourself and your clinician to ensure that it is both clinically appropriate and meets the needs of your treatment. In Out of Office Sessions the clinician will complete a risk assessment to assess suitability for this service and we ask all clients to be mindful of their environment and any hazards or risks that may be present. The Risk Assessments conducted can be requested as needed.
We ask all clients to be aware and agree to the following;
Reasons why a clinician may advise against Out of Office sessions are;
LIMITATIONS OF OUT OF OFFICE SESSIONS
An Out of Office Session may be subject to limitations such as traffic impacts/delays, environmental risks, or weather concerns which may affect the ability to conduct the session appropriately. In addition, there may be some services for which Out of Office sessions are not appropriate or effective. Your clinician will consider and discuss with you the appropriateness of ongoing Out of Office sessions.
If issues interfere with the session to the point that we cannot continue, your clinician will call you on the phone to discuss your options, which may include continuing the session by phone, telehealth or in office.
Based on client needs there may be some clinicians that offer formal assessments as a part of treatment. If you have sought out treatment through Mind Mode specifically for a formal assessment, your welcome email would have included/will include an Assessment Booklet which provides a basic structure of the sessions and fee scheduling.
Formal Testing and Assessment will be a collaborative process by which your clinician will discuss with you the structure, benefits and consequences of any assessment you undertake.
SOFTWARE USED FOR ASSESSMENT
The clinician utilises various software programs to access to the appropriate testing and assessment information and tools. Each clinician conducting testing and assessment has access to these shared resources.
Each clinician using any shared practice software has agreed and signed documentation indicating they will uphold the confidentiality principles by not accessing any information regarding clients not allocated to their case load.
Once your assessment information and process is completed, your information will be securely stored in your client file and removed from the assessment software database.
ASSESSMENT FEES
The cost of each psychological assessment can vary based on differing factors. Your clinician may conduct an initial assessment meeting where they will gather information to agree on assessment goals and provide you with a quote for the assessments they recommend.
For more information regarding fee scheduling please ask our friendly admin team for the Assessment Booklet.
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 (https://mindmode.com.au/fees) and can be discussed with reception. This fee is payable prior to your session, through card, cash or online payment. Your clinician will discuss with you your eligibility for Medicare or other compensable funding.
Mind Mode Psychology and Wellness Services
Wollongong | Campbelltown | Online
Email: admin@mindmode.com.au
Locations:
Level 2/310 Crown Street, Wollongong NSW 2500 | Phone: (02) 4288 4667
11b Chamberlain Street, Campbelltown, NSW, 2560 | Phone (02) 7228 8388