Client consent form
Before starting counselling sessions with Anne Kemp, you need to agree to the following terms:
Your counselling sessions will be maintained in strict confidentiality, except in circumstances where there exists a risk of harm to either yourself or others.
The counsellor may seek consultation with her supervisor in case of an emergency to maintain the quality of care while safeguarding the client's identity.
You have the right to ask questions and make informed decisions about your participation in counselling.
Your counsellor is a registered NZAC counsellor in New Zealand and follows all relevant regulations and Codes of Ethics.
Please do not record any counselling sessions with any device.
Your counsellor will keep detailed client records confidential and secure.
For paying clients, fees are payable before each session through internet transfer (details below).
If you need to cancel a session, you must do so at least 24 hours in advance, otherwise you will be charged 50% of the fee for that session.
If your counsellor is unable to provide services to you, they will try to refer you to other professionals.
After your final counselling session has been completed, you will receive a client evaluation form for your feedback. If you prefer not to receive the evaluation form, please communicate this preference to your counsellor.
By completing the form below, you acknowledge that you have read and understood these terms and agree to participate in counselling with Anne Kemp.
Bank Account details:
Projects for Humanity Ltd.
ASB, 12-3254-0199682-00