Consent for Service

Your consent is required to provide a psychological service. Your psychologist will explain to you the benefits and any potential risks of accessing psychological services. Please ensure that you fully understand the service information provided and ask for further information if you are unclear as to the information outlined in this consent form.

Personal Information

As part of providing a psychological service, such as a psychological assessment or treatment, we will need to collect and record personal information that is relevant to your current situation. This information is a necessary part of the services provided and guides treatment. You do not have to give all of your personal information, but choosing not to share your relevant information may mean that the psychological service may be affected.

Purpose of Collecting and Holding Information

Your personal information is gathered as part of your assessment and treatment. Your information will be confidentially retained to document what happens during sessions and enable the psychologist to provide a relevant and informed psychological service to you.

At times, with your consent we may also gather information from others to help to inform the psychological service.  That information is treated in the same way as your personal information.

Information Storage

Your information is stored securely. It is only accessed by your psychologist and as required, by authorised staff and personnel engaged by the practice, in accordance with the practice’s privacy policy. Your information is stored using secure electronic systems and physical filing systems that adhere to Australian Privacy laws. Psychologists are required to keep your file for a minimum of 7 years or, if clients are under the age of 18 at the time of treatment, until they are 25 years of age. A more detailed description is provided in the practice’s “Privacy policy”, which can be obtained by requesting a copy from your psychologist, or can be accessed via the practice website (www.drelisabethbakes.com.au). If you have concerns that the information recorded is not correct, please discuss your concerns with your psychologist.

Consequences of Not Providing Personal Information

Psychologists are required to keep clear and accurate client records as part of their professional obligations. If you do not wish for your personal information to be collected, we may not be able to provide the psychological service to you. Please discuss any concerns you have with your psychologist.

Accessing Your Personal Information

At any stage, you are entitled to access your personal information kept on file. There may be some exceptions to this, which are outlined in the relevant legislation or policies. If you would like to access your information, please discuss it with us or you can request in writing.

Confidentiality of Information

Personal information gathered by your psychologist will remain confidential except for certain circumstances. In most cases, any sharing of information will only occur with your consent. Our practice asks for your consent to share information when:

·        Sharing information with a family member, guardian or carer.

·        Discussing with others, such as your GP, employer, or any agencies which may be paying for your attendance.

·        Providing a written report regarding your assessment or treatment to another professional or agency, such as your GP, lawyer or insurance company.

·        For disclosing the information in any other way not referenced in this document.

Psychologists are required to consult and receive supervision from colleagues from time to time. If your information is shared in this context, all care is taken to deidentify your information in such a way that you remain anonymous.

Exceptions to Confidentiality

There are times when your psychologist may release your information without obtaining your consent such as:

·        When a court requires information by issuing a subpoena, or providing information is otherwise required or authorised by law.

·        When it is required because the psychologist must make a mandatory report on a concern.

·        When the psychologist discloses information because they believe you or someone else is at risk of serious harm.

How to Make a Complaint

If you have any concerns about your contact with our clinic, please discuss these with your psychologist, either in person, by phone or in writing.

Fees

The cost of consultation is outlined below. 

Standard consultation is 60 minutes. 

The fee structure for service is:

• Individual Consultation:  $280 for 60 minute session

• Couples Consultation: $300 for 60 minute session

• Cancelled Session:  More than 24 hrs notice – no charge

  Less than 24 hrs notice - $100

• Non Attendance Without Notice:  Full fee (Individual $280 / Couple $300)

Payment is required on the day of attendance.

The following payment options apply:

• Cash

• Credit/Debit Card (surcharge applies – 1.9% + $1.00)

• Direct Bank payment

Cancellation Policy

If, for some reason, you need to cancel or reschedule your appointment, please give at least 24 hours notice. This clinic has a policy regarding late cancellation.  If less than 24 hours notice is given, you will be charged in accordance with the above fee schedule. Settlement of this account is required prior to further sessions being scheduled.

Privacy policy for the handling of personal information 

This document describes the privacy policy of Dr Elisabeth Bakes, Clinical Psychologist, for the management of your personal information. The psychological service provided is bound by the legal requirements of the Australian Privacy Principles set out in the Privacy Act 1988 (Cth).

Personal information

Your information is stored securely and accessed only by your psychologist and the authorised staff or providers of the practice, as required, in accordance with the practice’s policies and procedures.  

Your information is stored using secure electronic systems and physical filing systems that adhere to Australian Privacy laws.

The information collected includes your personal details such as name, address and contact phone numbers. As part of providing a psychological service, such as a psychological assessment or treatment, we will also need to collect and record other personal information that is relevant to your current situation. This includes keeping a record of what happens during sessions, any psychological tests you complete, and any information received from others, such as your GP, solicitor or insurance company.  

Relevant payment details will also be collected, depending on your preferred method of payment for your session.

How your personal information is collected

There are a number of ways your personal information is collected, including when: 

• You provide information directly to Dr Elisabeth Bakes in your session and in writing such as letters, email or text messages.

• Other health practitioners, such as your GP, provide personal information to Dr Elisabeth Bakes, through referrals, correspondence and medical reports.

• I receive personal information from other sources, such as lawyers, employers or insurance companies through correspondence or reports. 

If you have concerns that the information recorded is not correct, please discuss your concerns with Dr Elisabeth Bakes.   

Purpose of holding personal information

Your personal information is gathered and used for the purpose of providing a psychological service to you. Your personal information is retained in order to document what happens during sessions and enables your psychologist to provide a relevant and informed psychological service to you. This information and record keeping is a necessary part of the services provided and guides treatment. Psychologists are required to keep your file for a minimum of 7 years or, if clients are under the age of 18 at the time of treatment, until they are 25 years of age

Consequence of not providing personal information

Psychologists are required to keep clear and accurate client records as part of their professional obligations.

If you do not wish for your personal information to be collected, we may not be able to provide the psychological service to you. Please discuss any concerns you have with your psychologist.

Accessing your personal information

At any stage, you can request to access your personal information kept on file. There may be some exceptions that impact your ability to access the information, which are outlined in the relevant legislation.  

If you would like to access your information, please discuss it with Dr Elisabeth Bakes or you can request in writing. All written requests for access to information will be responded to in writing within 30 days per the Privacy Act and an appointment will be made if necessary for clarification purposes.  

Confidentiality of information

Personal information gathered by your psychologist will remain confidential except for certain circumstances. In most cases, any sharing of information will only occur with your consent.

Our practice asks for your consent to share information when:

·        Sharing information with a family member, guardian or carer.

·        Discussing with others, such as your GP, employer, or any agencies which may be paying for your attendance.

·        Providing a written report regarding your assessment or treatment to another professional or agency, such as your GP, lawyer or insurance company.

·        For disclosing the information in any other way not referenced in this document.

Psychologists are required to consult and receive supervision from colleagues from time to time. If your information is shared in this context, all care is taken to deidentify your information in such a way that you remain anonymous.