CHANGES Psychological Services – Privacy Policy and CONSENT FORM
Introduction
Our Privacy Policy provides you with information regarding how your personal information is collected and used within our psychology practice, and the circumstances in which we may share it with third parties.
Your consent
When you become a client of this practice, you provide consent for our psychologists to access and use your personal information, so they can provide you with the best possible health care. Only staff who need to see your personal information will have access to it. If we need to use your information for anything else, we will seek additional consent from you to do this.
Your personal information
Our practice collects your personal information to provide health care services to you. Our main purpose for collecting, using, holding and sharing your personal information is to manage your health.
The information we will collect about you includes:
• Name, date of birth, address, phone numbers and other relevant contact details
• Relevant health and medical information, including any information provided by your GP, specialist or other allied health professional through referral processes
• Medicare number for claiming purposes
We collect, hold and use your personal information for a number of purposes:
• To ensure you receive the best care possible while you are a client at CHANGES Psychological Services
• To send communications such as reports, summaries and reviews to any relevant referring or treating doctors, specialists or other allied health professionals
• To provide relevant information and advice to you
• To update our records and keep your contact details current
Our practice may collect your personal information in a number of ways:
• When you first visit our practice, you will be required to fill out the Initial Consultation Client form, which collects your contact details and basic medical information
• During therapeutic intervention or assessment
• We may also collect your personal information when you send us an email or an SMS, telephone us, or communicate with us using social media
• In some circumstances, personal information may also be collected from other sources, such as: your guardian or responsible person, other health or education providers invested in your care, or via your health fund, Medicare or NDIS
A Request and Consent to Release and/or Share Confidential Records and Information form can be requested. This form is used when you wish for another health or education provider to share relevant observations, reports, records or summaries with us.
At times we may need to share your information:
• With other health care providers, such as your GP, specialist or other allied health professional
• When it is required or authorised by law, such as a court subpoena
• When it is necessary to lessen/prevent a serious threat to a client’s life, health/safety, or public health/safety (harm to self or others)
• When there is a statutory requirement to share certain personal information
• Supervision/Second opinion Under national law, registered psychologists are required to seek supervision from a colleague approximately once per month to discuss their practice. It is possible that some aspects of your treatment will be discussed with another psychologist. If this is undertaken your name or other identifying details will not be used.
Only people who need to access your information will be able to do so. Other than in the course of providing health care services or as otherwise described in this policy, we will not share personal information with any third party without your consent. Our practice will not share your personal information with anyone outside of Australia (unless under exceptional circumstances that are permitted by law) without your consent. Neither will our practice use your personal information for direct marketing without your consent.
Our practice will store your personal information in various forms:
• Electronic records
• Paper records
Our practice stores all of your personal information respectfully and responsibly:
• In secure and protected Information and Communication Technology and storage systems
You have the right to request access to your personal information:
• Depending on the way in which you wish to access your personal information, we may require up to 30 days to process your request
• The fee for this service will be calculated based on time and resources used in the process of retrieving, collating and disseminating the information requested
• The Privacy Act states that we can reject this request if we believe we have due reason
• If we reject your request, a reason will be provided in writing
You have the right to request correction of your personal information:
• We ask that you put this request in writing and shared with your psychologist
• The Privacy Act states that we can reject this request if we believe we have due reason
• If we reject your request, a reason will be provided in writing
Our practice likes to ensure your details are always accurate and up-to-date:
• If you move to a new home or change your phone number, please let us know as soon as possible so we can update our records
• You can update your details by emailing talkto.changes.psych@gmail.com
Complaints Process
We take complaints and concerns regarding privacy seriously. You should express any privacy concerns you have in writing, and discuss with your psychologist. We will attempt to resolve any issues. You may also contact the Office of the Australian Information Commissioner (OAIC). Generally, the OAIC will require you give them time to respond before they will investigate. For further information, visit www.oaic.gov.au or call the OAIC on 1300 363 992.
Fees
The cost of a psychological counselling session lasting 55 minutes is $180.00 which is payable at the end of the session by either credit/debit card or cash
Cancellation
If for some reason you need to cancel or postpone your appointment, please give the psychologist at least 24 hours notice by phoning 02 4913 5656 to avoid a cancellation fee
Australian Psychological Society Charter for Clients of Psychologists
The attached Charter explains your rights as a client of a psychologist
I, _______________________________________ have read and understood this CONSENT FORM. I agree to the conditions for the psychological service provided by Jane Stevenson, AHPRA registered PSY0001170180 at CHANGES Psychological Services.
Signed ……………………………………………….. Date …………………………………….