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Consent and Confidentiality

Thank you for giving Odé Counselling the opportunity to support you and help you reach your goals. It takes a lot of courage to reach out for support and we’re pleased to walk this journey with you. Please read the entire document and ask about anything that may be unclear to you. A signature at the end is required and this states that you agree and understand all information provided.

Client & Counsellor Relationship

It is my hope that we can work together. It is important that we work as a team to ensure you meet your overall goals. Every person has a gift and we will work together to identify your gifts.

Session

Appointments are scheduled at 60 minutes per session. Each session may be face-to-face, virtually and/or via telephone calls. It will be dependent on your comfort level. Every session, we will build on your goals and treatment plan(s). It may include the following:

• Identifying your strengths;
• Assist you in identifying thoughts, feelings, and/or behaviours;
• Developing a plan for overcoming any obstacles;
• Finding community resources to support your goals;
• Possible tasks to be given in between therapy sessions to assist in your goals.

Confidentiality

All information is kept confidential. Any information that is shared in sessions will be kept confidential. All records are locked in a safe place and will only be accessed by your counsellor. If you choose to communicate via email or any other electronic format – it will be limited to complete confidentiality. It is important that you understand this when using electronic forms of communication.

If you would like to share information from our sessions with another professional, I will need a form signed by you. The form gives me permission to release/request information.

Client Rights

If you have any questions or concerns about the services and/or your treatment plan, please let your counsellor know. You may stop therapy at any given time if something is not working for you. We can refer you to another counsellor if you feel that is what you need. Be open and honest with your counsellor. We will always support you and your decisions

Overriding Duty of Confidentiality

• If you threaten to harm or kill yourself or others – we will need to let the proper authorities know;
• If you disclose any type of abuse (physical, sexual, emotional and/or neglect) towards anyone under the age of 18 – we will need to report it to authorities;
• If you’re involved in court matters – it is possible for the court to request your file. A court can subpoena any information that is in your file/record and we would be obligated to share it with them.

If Your Counsellor is Unavailable

If your counsellor is unavailable due to unforeseen circumstances or time off, your counsellor will identify the time frame, on voicemail or in-person, in which he/she will be unavailable. If you’re needing to meet with someone during this time – you can let your counsellor know and he/she will suggest another counsellor until he/she returns. In case of emergency, please call the Manitoba Suicide Prevention and Support Line at 1-877-435-7170, call 911 or go to your nearest hospital emergency room.

Cancellation Policy

Every client’s needs are equally important therefore we require a 24-hour notice for cancelling your appointment. This ensures that your counsellor is using their time efficiently to help as many clients as possible. If you do not cancel your appointment or miss your session without notice – you will be required to pay the full amount. If you cancel within the 24-hour period prior to your appointment, you will need to pay 50% of the total amount.

Cancelling your Counselling Services

When you begin your counselling sessions, you will work with your counsellor to develop goals to support your overall wellness plan. It will be up to you and your counsellor to decide when services are complete. It is recommended that you complete your treatment plan before cancelling any services.

Agreement

By signing this form – I understand and agree to the following:

1. A 24-hour notice needs to be provided when cancelling or changing an appointment;
2. To fully participate and engage in each session with my counsellor;
3. All information is confidential and my counsellor explained any limits to confidentiality.

I have read, understand, and agree to the information on this form.