1. Sarah Coffey of ADHD Therapy Australia is your treating "psychologist" responsible for your care, you are "the client" (yourself or person you are organising services for), and Changes Psychology is the admin and billing service "provider" that is only responsible for processing clients' bookings, billing and client administration only on behalf of your treating psychologist. By signing this agreement you are agreeing to the provision of services under this arrangement.

2. Privacy - ADHD Therapy Australia and Changes Psychology take your privacy seriously. We work like a virtual clinic office, collecting and managing personal and medical information digitally from you and your psychologist, which naturally includes sensitive health information. We collect, use and (where appropriate) store this information, which includes health information, in order to facilitate appointments with psychologists; manage payment, medicare and insurance claims; and manage records regarding your appointments. The provider's handling of personal information involves some processing of client information by employees and contractors, some of which are based overseas. We manage your information in accordance to ethical guidelines and respective Australian Privacy Laws. For more about privacy, and who to contact if you have questions or complaints regarding privacy, please refer to the providers full privacy policy here changespsychology.com.au/privacypolicy

3. Confidentiality of information collected for Psychological Services - You can be assured that all personal information gathered by this form and within psychological sessions will remain confidential and secure.
However, it is important to know there are exceptions in which psychologists are mandated by the law to wave confidentiality. This can occur in one or more of the following scenarios;
A. The information you have provided to your psychologist is subpoenaed (officially requested) by a court of law
B. Failure to disclose certain information would place you or another person at serious risk of harm.
C. Psychologists are by law mandated to report all cases of child abuse and mistreatment.
D. Your prior consent has been obtained to;
i) Provide a written report to another professional or organisation. e.g. A letter to a GP or Lawyer ii) Provide details to a third party (only if written consent was given prior)
E. Non-clinical details such as medicare numbers, referring doctors names, appointment times and other information considered important for administrative tasks may be accessed by administrative staff in the course of there work.
Where possible, you will be advised that a notification will be made, however, this may not be practical at all times due to safety or legal reasons. If you have any concerns that the information you would like to share may incriminate yourself or another, please notify your therapist and they will discuss this concern with you prior to giving details and/or other implicit information.

4. Medicare Rebates
Medicare rebates can be claimed for therapy (not assessment) sessions if you provide a valid referral and Mental Health Plan from your GP or Psychiatrist. The $96.65 Medicare rebate can only be claimed after a session has occurred and been paid for. Medicare rebates cannot be paid for ADHD assessments or cancellations.

5. Session fees - Fees are charged at $210 per 50 minute session. Fees will increase periodically to cover increased practice costs. All session fees will be deducted from a credit or debit card you provided and stored for future use. Direct deposit is not a payment option. Medicare rebates of $96.65 will be processed after payment is received if you have provided a valid Mental Health Plan and Referral from a referring doctor. Medicare rebates cannot be claimed for ADHD assessments.

6. Cancellation Policy - SMS reminders for appointments are sent to clients 2 days before their scheduled appointment, and email reminders sent 1 day prior to sessions. Cancellation fees are charged if less than 24 hours' notice is given, and a $50 fee is payable if you fail to give more than 24 hours notice that you cannot attend. In the case of patients with multiple cancellations, to book an appointment a non refundable advanced payment of the session fee may be required to book an appointment.

Sarah Coffey Psychologist

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