Office Policies

Fees and Payment
Rates
$120 per 60 minute session

As a Medicare provider, a $70 rebate per session is available upon referral from your General Practitioner.  In accordance with Medicare policy, you will be required to renew your referral every 6 sessions, to a total of 12 sessions, or 18 sessions subjected to assessment of needs.

Payment is due at the time of service.  Invoicing and payment will take place at the end of each session. An invoice for each session will be provided to you, so you can then claim your reimbursement from Medicare offices.  I accept cheques and cash only.
 
Canceling Appointments 
If it is necessary for you to cancel an appointment, please do so a full 24 hours prior to your scheduled session.  Appointments that are missed, or are canceled with less than 24 hours notice will be charged at the regular fee for the hour that was set aside for you.  A message left on my voice mail is adequate for canceling your appointment, even during evenings and weekends.  Please do not use e-mail to cancel appointments, because I may not be able to access it promptly.

Assessment Procedures and Reports
Some clients are referred for issues that require testing and/or reports for insurance companies or the court.  If relevant, I will discuss the costs of these services with you at the time of service.  I do not charge to complete simple forms, but I do charge for writing letters and reports.

Confidentiality and the limits on confidentiality

As a mental health clinician, I have the ethical responsibility to protect your confidentiality.  This means that, whenever I can legally do so, I will keep private the information that you give to me.
 
To make sure that your confidentiality is protected, I will not release information to anyone (other than your referring doctor) unless I have your written permission to do so. You may withdraw permission to release information at any time by simply informing me that you wish to withdraw consent.

For all counsellors and psychotherapists, there are limits on confidentiality.  You need to be aware that there are times when I cannot promise to keep information private.  The following are examples of circumstances in which I may have to break my promise of confidentiality.

1. If I feel that you are going to commit suicide, I must contact someone who can protect you from carrying out your plan.
2. If you indicate that you are going to harm someone else, I must let that person and the authorities know that he or she is in danger.
3. If you tell me about any child abuse case that has not already been brought to the attention of authorities, I must contact appropriate people (e.g., Child Protection Authority). 
4. If you tell me that you have been sexually abused by any licensed health care professional, I am obliged to report the alleged abuser to the authority that governs that person.  You, as the client, can choose to remain anonymous.
5. If my file about you is subpoenaed by a Court, I am obligated to provide them with a copy of my entire file or any part that they wish to have.  I can also be subpoenaed to provide testimony.

Consent to treatment

By signing this form, you confirm that you have read the information provided on the three previous pages, that you understand my office policies and the limits on confidentiality as listed, and that you agree to provide information to me under those conditions.

I have read and accept the description of Office Policies as well as Confidentiality and the Limits on Confidentiality.