I, the client (or guardian if client is under 18) agree to participate in therapy and give consent for my therapist to disclose & receive information/reports to and from my emergency contact and my referrer, as well as other supports I give consent for.

I also acknowledge that I have read and agree to my rights and responsibilities in relation to therapy and regarding the Therapy Dog and consent to participate.

Before your first session: Email the following to info@beaconis.com.au

Signed and completed Service Agreement consent form
Funding Confirmation: Mental Health Treatment Plan and GP referral, or TAC claim number, VOCAT approval or NDIS plan.
Any assessments you have been asked to complete

There is often a wait list for services. The length of this can be discussed with you before you upon
Treatment may include: capacity building interventions such as EMDR, animal assisted therapy, therapeutic art activities and other therapies.

Clinic Details

26a Hardy Street Lilydale: Parking and entry is around the back of the building.
Book your in-clinic sessions with Bec or Mel: https://www.halaxy.com/book/appointment/beacon-innovative-solutions-lilydale/location/1244441

FEES

Session duration is 60 minutes.
Full payment needs to be paid on the day of service. This will be through paying by card in the clinic, or for non-clinic sessions, through direct debit with your account details provided on this form.
The Medicare Rebate will be automatically processed on the night of your appointment and should be in your Medicare registered bank account within 1-2 business days.
Your automatic Rebate Claim will only be approved by Medicare if you have a valid/current Mental Health Care Plan and Referral Letter from your GP, which has been provided before your appointment.
You need to advise if any sessions have been claimed on the current plan or during the current calendar year.
You can receive up to 10 sessions on a MHTP each calendar year. An Initial 6 sessions, then an additional 4 sessions after a review with your GP. It is your responsibility to track sessions used, to ensure you are eligible for rebates.
To claim medicare rebates for children under 15 years old, we also require the parent’s Medicare details, name and date of birth.
To obtain a Mental Health Care Plan or Chronic Disease Management Plan: schedule a double appointment with your GP.
We may request to quarantine your NDIS funding for your therapy sessions each year.

Cancellation Policy:

If you cancel within 48 hours you will need to pay – 100% of the fee
If you do not have a current/valid NDIS plan or Mental Health Care Plan at the time of your session, you will be billed at the full rate.
The amount of sessions will be negotiated and set, depending on your Plan and the availability of your therapist.
Approval of using your NDIS Plan or Agency Funding for this service will need to be provided prior to your first session.
As a NDIS non-registered provider, I cannot provide a service if you are NDIA managed.

FUNDING SOURCES:

NDIS support item: 15_621_0128_1_3 - Counselling: CB Daily Activity	$193.99	Bec
NDIS support item: 15_053_0128_1_3 - Therapy Assistant - Level 2	$86.79 + travel	Mel
Financial Assistance Scheme (VOCAT)	$195	Bec
Agency Funded	$195	Mel & Bec
Mental Health Care Plans (#80160) Medicare rebate: $85.20 (sessions can be provided at a discounted rate of $135.20: making the gap $50)	$135.20	Bec
TAC (SW606) TAC rebate: $115.70 (sessions can be provided at a discounted rate of $165.70: making the gap $50)	$135.20	Bec
Chronic Disease Management Plans (#10956) Medicare rebate: $60.35 (sessions can be provided at a discounted rate of $135.20: making the gap $74.85)	$135.20	Bec
Client paid - Low Fee - no additional funding	$135.20	Mel & Bec

As a client you have the following rights and responsibilities:

Your consent will be sought for contact with any other people, services or professionals unless it is assessed there is reasonable belief of a harm to yourself (such as suicide, physical or mental harm), harm to someone under the age of 18, harm to others or family violence. Confidentiality will also be broken if your secure file is legally subpoenaed.
Medical treatment, ambulance or emergency services will be sort in emergency situations.
Respect will be shown to you and for your cultural background and language.
We will receive a clear explanation of the service you will receive.
We will be clear and transparent regarding our assessment of your priorities and counselling needs.
You will receive an explanation about confidentiality and its limits.
Your Therapist may need to discuss your situation with other professionals during supervision (or consultation), in order to best meet your needs. In these situations identifying information will not be provided in order to safeguard your identity.
We will let you know as soon as possible of any cancellation or changes to your appointment due to the illness or unavailability of your Therapist.
You are free to terminate your service at any time.

Consent for Therapy Dog:

I consent to participating and interacting with Tilly the Therapy Dog or Evie the Therapy Dog within my counselling sessions. I have read and understand the following statements regarding my participation.

I acknowledge that I have no known illness or allergies which would prevent me from interacting with and handling the Therapy Dog. I understand that the Therapy Dog undergoes routine vet checks and preventable medicine (including vaccinations, worming etc to maintain their health; however there are some illness which can pass between humans and dogs to which I may be exposed to.I understand that the Therapy Dog is trained, socialised and certified to work with people; however I acknowledge risks associated with working with animals, including risk of injury and forgo any rights in response to this. go any rights in response to this.

Melissa Smart Other

Info

Fees/Services