Consent Form

Please read through the following informed consent agreement. What follows is a basic understanding between client and therapist. In general, what are listed below are the responsibilities and obligations of your therapist, and also some expectations of you as the client. This document also contains important information about our professional services and business policies. Do not sign the informed consent unless you completely understand and agree to all aspects.

Therapy begins when one opens about themself and their life experiences. In order to bring out one's self-awareness, sharing that experience with the therapist is necessary. The therapist then helps reflect back to the client the information and helps on addressing the concerns. While undergoing therapy, old wounds, painful emotions, or traumatic experiences may be opened up again and may cause distress or discomfort. This is part of the working progress of one's therapy.

All clients voluntarily agree to treatment, and accordingly may terminate any time without penalty. Counseling involves a large commitment of time, money, and energy, so you should be thoughtful about the therapist you select. In the first couple of sessions, you should be deciding whether your therapist is right for you. If you feel it is not a good match, then your therapist will be happy to assist you in finding a new therapist.

All clients are expected to show up to appointments on time, prepared to focus on and discuss therapy goals and issues, and will not attend while under the influence of mood altering chemicals. All clients are expected to be open and honest so your therapist can assist you with your goals. Counseling is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for therapy to be most successful, you are encouraged to work on things we talk about both during our sessions and at home. Inconsistent attendance can negatively affect your therapy progress.

Your therapist will be prepared at the designated time, (barring emergencies), and will be attentive and supportive in meeting the therapy goals and do everything possible to assist you in achieving a greater sense of self-awareness and work toward helping you resolve problem areas.

In keeping with standards of practice, your therapist may consult with other mental health professionals regarding care and management of cases. The purpose of this consultation is to ensure quality of care. Your therapist will maintain complete confidentiality and protect your identity by not using real names or any identifying information. Please note that your counselor may refer you to another health care provider if they can better meet your needs.

Session length: 50-55 mins. You will be expected to pay for each session within 3 hours of your booking confirmation, failure to do so will result in cancellation of your appointment. Your therapist reserves the right to modify the counselling fees at any point.

Once your appointment is scheduled, you will be expected to pay for it unless you provide at least 24 business hours advance notice of cancellation. If you do not provide at least 24 business hours’ notice, or fail to show for a scheduled appointment, you will be responsible for the full cost of the session. Once the payment has been made, it will not be refunded in case of cancellations or a no-show from the client. If you do not reschedule or make contact with the counselor within 3 months, it will be assumed that you are no longer interested in continuing counseling. If you would like to return to counseling , you need to make a new appointment. Please follow the counseling policies throughout the course of counseling. If your medical condition becomes unstable or you violate the policies, the counselor may terminate the service.

Information discussed during your therapy session and all documentation is kept private and confidential. If you are receiving treatment or counseling from other medical facilities or services , your counselor may contact your doctor or person in charge with your consent. Counselors don't disclose your information without your consent. Some very important exceptions to this rule are : (1) If there is a legal responsibility for the therapist to release information contained in records. (2) If we believe that you are threatening imminent physical injury to yourself or another person. (3) If there is a reasonable expectation that you will engage in dangerous conduct as defined by law. (4) If there is reasonable suspicion that a child or elder is currently being abused.

If you have any questions with regard to the therapy and its progress, or if you're getting unhappy with the therapy progress, please let us know immediately so we can address your concerns as soon as possible. Your criticisms and views are important to us. Feel free to contact us through our email address or phone number. You can also discuss your issues regarding therapy with your therapist.

Your signature below indicates that you have read the entire Kalm Therapy Consent Form, which contains information on clinical services, sessions, professional fees, cancellation and no-show policies, billing and payments, contacting us, professional records, confidentiality, and practice status, and you agree to abide by its terms throughout our professional relationship.