The Psychology Consent Form Template is an essential document for mental health professionals practicing in Australia, designed to establish a clear therapeutic agreement between practitioners and clients. This document is required before commencing psychological services and must be implemented in accordance with Australian healthcare legislation, privacy laws, and professional standards. The template covers crucial aspects including informed consent, confidentiality limits, fee structures, record-keeping practices, and client rights, while adhering to requirements set by the Psychology Board of Australia and relevant state/territory regulations. It serves as a foundational document for establishing the therapeutic relationship and ensuring both practitioners and clients understand their rights, responsibilities, and the parameters of the professional service being provided.
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1. Practice Information: Details of the psychology practice, practitioner(s), contact information, and emergency contacts
2. Nature of Services: Clear description of psychological services being offered, including types of therapy or assessment
3. Confidentiality and Privacy: Explanation of confidentiality principles, limits to confidentiality, and how personal information is handled under Privacy Act requirements
4. Fees and Cancellation Policy: Details of service fees, payment methods, Medicare or private health insurance claiming, and cancellation/no-show policies
5. Client Rights and Responsibilities: Overview of client rights, including right to refuse treatment, ask questions, and terminate services
6. Record Keeping: Information about how clinical notes and records are maintained, stored, and accessed
7. Consent Declaration: Formal acknowledgment and signature section confirming understanding and agreement to terms
1. Telehealth Services: Required when offering remote psychological services, including specific privacy considerations and technical requirements
2. Group Therapy Provisions: Required for group therapy services, including additional confidentiality considerations and group-specific policies
3. Minor Client Provisions: Required when working with clients under 18, including parental consent and specific confidentiality arrangements
4. Research Participation: Required when clinical services may involve research components or data collection for research purposes
5. Crisis Management: Required for services involving high-risk clients, detailing emergency procedures and after-hours support
6. Third Party Involvement: Required when services involve third party payers or referrers (e.g., workplace EAP, insurance companies)
1. Fee Schedule: Detailed breakdown of all service fees, Medicare rebates, and additional costs
2. Privacy Policy: Detailed privacy policy compliant with Australian Privacy Principles and relevant health records legislation
3. Client Rights Charter: Comprehensive outline of client rights and available complaint procedures
4. Practice Policies: Detailed practice policies including appointment scheduling, communication methods, and emergency procedures
5. Information Security Protocol: Details of how client information is protected, including digital security measures and access controls
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Healthcare
Mental Health Services
Education
Corporate/Employee Assistance Programs
Government Services
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Private Practice
Research Institutions
Community Services
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Relevant Teams
Legal
Compliance
Clinical Operations
Mental Health Services
Healthcare Administration
Quality Assurance
Risk Management
Professional Standards
Client Services
Research & Development
Relevant Roles
Psychologist
Clinical Psychologist
Counseling Psychologist
Mental Health Practitioner
Practice Manager
Clinical Director
Healthcare Administrator
Mental Health Researcher
Psychology Supervisor
Compliance Officer
Legal Counsel
Mental Health Program Manager
Employee Assistance Program Coordinator
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