The Counselling Consent Form Template – Australia is offered in multiple formats, including PDF, Word, and Google Docs. These formats are both customizable and ready for printing, designed to fulfill your requirements effortlessly.
Counselling Consent Form Template – Australia Editable | PrintableSample
1. Client Information 2. Counsellor Information 3. Purpose of Counselling 4. Nature of the Counselling Sessions 5. Confidentiality Policy 6. Informed Consent 7. Rights of the Client 8. Fees and Payment Terms 9. Session Duration and Frequency 10. Emergency Contact Information 11. Signatures and Acceptance
PDF
WORD
Examples
[Client’s Name]
[Client’s ID]
[Client’s Address]
[Client’s Phone]
[Client’s Email]
[Counsellor’s Name]
[Counsellor’s ID]
[Counsellor’s Address]
[Counsellor’s Phone]
[Counsellor’s Email]
This Counselling Consent Form (“Form”) outlines the agreement between the Client and the Counsellor for the provision of counselling services, effective from [Start Date].
Counselling aims to provide support to the Client in addressing emotional, psychological, and relational issues, and to improve overall well-being.
All information shared in counselling sessions will be treated with strict confidentiality, except in situations where there is a risk of harm to the Client or others.
The Client understands the nature of the counselling process, including potential risks and benefits, and gives consent to receive counselling services.
Counselling sessions will be conducted on a [weekly/bi-weekly] basis, each lasting approximately [duration] minutes.
The Client agrees to pay a fee of [amount] per session. Payments are to be made [upon receipt of service/within 7 days of invoice].
The Client must provide at least [Notice Period] notice for cancelled appointments; otherwise, a cancellation fee may apply.
This agreement will remain in effect until terminated by either party with written notice of [Notice Period].
This Form shall be governed by the laws of Australia.
[Client’s Signature]
[Client’s Name]
[Counsellor’s Signature]
[Counsellor’s Name]
[Client’s Name]
[Client’s ID]
[Client’s Address]
[Client’s Phone]
[Client’s Email]
[Counsellor’s Name]
[Counsellor’s ID]
[Counsellor’s Address]
[Counsellor’s Phone]
[Counsellor’s Email]
This Counselling Consent Form establishes the agreement for counselling services between the Client and the Counsellor, starting from [Start Date].
The Client seeks to engage in counselling aimed at identifying and resolving personal issues, enhancing emotional resilience, and promoting mental health.
The Counsellor commits to maintaining the confidentiality of all discussions and records related to the Client, except as required by law.
The Client acknowledges that while counselling can be beneficial, it may evoke strong emotions and discomfort during the process.
Counselling sessions will be scheduled based on mutual availability, and each session will last approximately [duration] minutes.
The Client agrees to pay the Counsellor a fee of [amount] per session, to be settled [on the day of the session/within 7 days after attending].
The Client must inform the Counsellor at least [Notice Period] in advance to avoid a cancellation fee.
This agreement can be terminated at any time by either party with written notice given [Notice Period].
This Form will be interpreted under the laws of Australia.
[Client’s Signature]
[Client’s Name]
[Counsellor’s Signature]
[Counsellor’s Name]
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