EAP/ SUPERVISION CLIENT FORM

By ticking these boxes I have read and agree to the terms outlined below

Confidentiality

Professional ethics require information conveyed by clients during sessions and any notes that are taken by the counsellor are to be kept private and confidential.

 

Women’s Health & Wellbeing Service does not prepare reports for third parties, such as, for example but not limited to, reports for legal representatives or the courts, doctors and social workers. (Except where a Mental Health Care Plan is being utilized and reports will be sent to my General Practitioner as per the Medicare requirement).

 

Women’s Health & Wellbeing Service will not release client information to any other party without my consent. There are however exceptions to this rule:

 

In the event that I may be in danger (i.e. of harming myself or someone else) contact will be made with the necessary professionals including the department of child protection, family or friends. I understand where possible I will be made aware and included in the process. If a session is not attended without any contact, I am aware that my counsellor will contact my next of kin family or friends to check on my wellbeing

 

On occasion in order to provide more effective therapy, a consultation process or collaboration with another suitably qualified professional* is maintained, as needed.

 

I have also been informed that my counsellor attends ongoing professional supervision in keeping with the highest standard of professional service delivery. No information given in supervision identifies me and therefore is still confidential.

 

Note: *These Health Professionals are then also bound by the same confidentiality guidelines.

Rights & Responsibility

Understanding your rights and responsibilities as a client of WHWS is central to our agency.

As a client of WHWS you have a right to:

  • Confidentiality

  • Share with a safe person what occurs in a counselling session

  • Be treated with care, dignity, respect and non – discrimination.

  • Be provided with a safe environment to conduct your session in.

  • Be involved in any treatment plan and decision making that impacts you.

  • Choose to use or not to use our services.

  • Be informed of any exchange of information that will be shared with any third parties.

  • Be informed of any cost associated with the use of the service.

  • A prompt service. Our goal is to provide the best possible service. If a session time needs to be changed every attempt will be made to contact you before the session time.

  • Have the complete attention of your counsellor and avoid interruptions during a session.

  • Receive accurate and relevant information in a timely manner.

  • Request a transfer to another staff member.

  • Make a complaint about the service received from WHWS and expect that this complaint will be investigated appropriately and in confidence.

  • Read your records with a WHWS representative in attendance.

 

As a client of WHWS you have a responsibility to:

  • Be respectful of others, including WHWS staff, volunteers, and other clients.

  • Be respectful of WHWS property.

  • Attend the service in a fit state (not under the influence of drugs or alcohol).

  • Ask questions of the service if there is something you do not fully understand.

  • Participate in the service to maximise your benefits (turn off mobile phones and pagers).

  • Maintain confidentiality regarding information about other clients or participants in groups or programs conducted by WHWS.

  • Provide accurate information about yourself in order to receive the best care.

  • Keep your scheduled appointment time and inform the agency of any inability to attend.  If you need to cancel an appointment please contact the office 24 hours before the appointment. Appointments not attended by clients without notification will be counted as an attended session and included in the sessions allocated. Or where a mental Health Care plan has been used a $30 fee will be charged.

  • Follow the strategies and agreed treatment plan which have been chosen in consultation with the service provider and communicate any possible barriers.

  • To pay any cost incurred for the treatment or transport in a medical emergency. In medical emergency WHWS staff will call for an ambulance.

Women's Health & Wellbeing Services

P: 08 9490 2258

F: 08 9490 1365

E: info@whws.org.au

Suite 7, Level 1 Gosnells Community Lotteries House

2232c Albany Highway Gosnells WA 6110

© 2020 by Women's Health and Wellbeing Services.