Name: Nektarios Alexi
Provisional Psychologist registration number: PSY 0001963830
CDU Psychology Clinic Phone number: 8901 8800
Consent Form
Mental Health service
As part of providing a psychotherapeutic psychological service to you or any kind of psychometric assesment, the Charles Darwin University Psychological Clinic has a policy to gather and save individual information provided by you that is pertinent to your personal situation, for example your name, information in which way and how is best to contact you, some relevant information in relation to your medical history and few more information as an integral part of providing mental health services to you.
It is a vital part of the psychological assesement and psychotherapeutic …show more content…
Your personal/private information is reserved just for the sake of document what occurs while you are in therapy or undertaking any psychological assesment, and allows the provisional psychologist to offer a high quality mental health service to you. If you wish you can have acess to a more comprehensive overview of the “Privacy policy for management of personal information”, which is possible to be gained by contacting CDU Psychology Clinic. The Privacy Policy enfolds information about how to proceed so to gain access and pursue alteration of your private/personal information, and explains how to lodge a complaint about any innappriorate way that any of the practitioners of this service misused your personal …show more content…
It is expected from the psychologist providing services to you to converse with you about the different ways of access to these information.
Private/Personal information disclosure
Any form of private/personal information collected by the provisional psychologist throughout the delivery of the psychology service will not be make known except unique circumstances such as:
1. If it is subpoenaed by a court; or
2. failure to disclose the information would in the reasonable belief of the CDU Psychology Clinic place you or another person at serious risk to life, health or safety; or
3. your prior approval has been obtained to
a) provide a written report to another professional or agency. e.g., a GP or a lawyer; or
b) discuss the material with another person, eg. a parent, employer or health provider; or
c) disclose the information in another way; or
4. disclosure is otherwise required by
Provisional Psychologist registration number: PSY 0001963830
CDU Psychology Clinic Phone number: 8901 8800
Consent Form
Mental Health service
As part of providing a psychotherapeutic psychological service to you or any kind of psychometric assesment, the Charles Darwin University Psychological Clinic has a policy to gather and save individual information provided by you that is pertinent to your personal situation, for example your name, information in which way and how is best to contact you, some relevant information in relation to your medical history and few more information as an integral part of providing mental health services to you.
It is a vital part of the psychological assesement and psychotherapeutic …show more content…
Your personal/private information is reserved just for the sake of document what occurs while you are in therapy or undertaking any psychological assesment, and allows the provisional psychologist to offer a high quality mental health service to you. If you wish you can have acess to a more comprehensive overview of the “Privacy policy for management of personal information”, which is possible to be gained by contacting CDU Psychology Clinic. The Privacy Policy enfolds information about how to proceed so to gain access and pursue alteration of your private/personal information, and explains how to lodge a complaint about any innappriorate way that any of the practitioners of this service misused your personal …show more content…
It is expected from the psychologist providing services to you to converse with you about the different ways of access to these information.
Private/Personal information disclosure
Any form of private/personal information collected by the provisional psychologist throughout the delivery of the psychology service will not be make known except unique circumstances such as:
1. If it is subpoenaed by a court; or
2. failure to disclose the information would in the reasonable belief of the CDU Psychology Clinic place you or another person at serious risk to life, health or safety; or
3. your prior approval has been obtained to
a) provide a written report to another professional or agency. e.g., a GP or a lawyer; or
b) discuss the material with another person, eg. a parent, employer or health provider; or
c) disclose the information in another way; or
4. disclosure is otherwise required by