Confidentiality, Release of Information, Fees & Informed Consent:
Please read the following statements regarding treatment. Completing this registration form means you agree to these terms:
Confidentiality, Privacy & Release of Information:
As part of providing service to you, we collect and record personal information from you that is relevant to your current situation. This information will be a necessary part of the assessment and treatment that is conducted.
All personal information gathered by The Social Confidence Collective during registration, assessment and/or intervention remains confidential and secure except in the following circumstances:
· It is subpoenaed by court
· The therapist becomes aware of any risk to yourself or others
· You agree to, and sign consent allowing material to be retrieved/forwarded to a third party, such as a GP or other clinician involved in your care.
· Please refer to our privacy policy attached to this form for further information.
Fees:
Applicable fees are to be paid within 7 days of receipt of invoice following an individual session unless otherwise negotiated with the clinician.
If you engage in any of our groups, the group fee package will be outlined in a NDIS Service Agreement. Following each group attendance, invoices will be sent to you or your plan manager and are to be paid within 7 days of receipt of each invoice.
Cancellations of Individual Appointments and Group Attendance:
If you need to cancel or re-schedule an individual appointment, we require notification 2 business days in advance. If your appointment is scheduled for a Monday, please contact The Social Confidence Collective before 10am on the previous Friday. For appointments on Tuesdays to Fridays, please provide 2 days’ notice.
If you provide less than 2 business days’ notice a 50% cancellation fee will apply. If no notice is provided, the full fee will apply.
As a courtesy, an email reminder will be sent to you prior to your scheduled appointment. If you need to reschedule an appointment, call or leave a voicemail (03) 9123 4127 or email hello@socialconfidencecollective.com.au. Not receiving a reminder is not sufficient reason to miss an appointment and the cancellation fee will apply.
Cancellations of Group Packages:
In the event that you are unable to attend a group as per your NDIS service agreement, The Social Confidence Collective reserves the right to charge a full group cancellation fee where 2 or less business days’ notice is given. This is as per NDIS guidelines. If there are unforeseen circumstances preventing your attendance at the group, please contact us to discuss.
Informed Consent:
In cases where the young person is under 18, and parents/guardians of a child are separated with a shared care arrangement or no formal custody arrangements, both carers must consent to the child undergoing treatment or therapy services at The Social Confidence Collective by signing this form.
This form must be completed at intake in order for treatment or services to proceed. The young person cannot receive treatment or services unless completed registration form has been received.