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1. Client and Therapist Information: Identifies all parties involved, including client's full name, therapist's name, qualifications, and registration details
2. Purpose of Therapy: Explains the nature and purpose of the therapeutic services being offered
3. Consent Declaration: Clear statement that the client understands and agrees to the therapy process
4. Client Rights: Outlines client rights under the Code of Health and Disability Services Consumers' Rights
5. Confidentiality: Details about confidentiality, its limits, and circumstances where information might need to be disclosed
6. Privacy Policy: Information about how personal data is collected, stored, and protected in accordance with the Privacy Act 2020
7. Session Information: Details about session duration, frequency, and scheduling policies
8. Fees and Payment: Clear outline of fees, payment methods, and cancellation policies
9. Emergency Procedures: Protocol for crisis situations and emergency contacts
10. Signature Block: Space for client and therapist signatures, dates, and witness if required
1. Telehealth Services: Required when offering online or remote therapy services, covering technical requirements and specific protocols
2. Group Therapy Provisions: Added when offering group therapy, including specific confidentiality requirements for group settings
3. Parent/Guardian Consent: Required when the client is a minor or lacks capacity to consent
4. Recording Consent: Used when sessions may be recorded for supervision or training purposes
5. Research Participation: Required if therapy is part of a research program or if data might be used for research
6. Cultural Considerations: Specific provisions for cultural safety and Treaty of Waitangi principles when working with M锟斤拷锟斤拷ori clients
7. Insurance and ACC Claims: Required when therapy services are covered by insurance or ACC
1. Schedule A: Detailed Fee Schedule: Comprehensive breakdown of all possible fees and charges
2. Schedule B: Privacy Statement: Detailed privacy policy and information handling procedures
3. Schedule C: Client Rights Summary: Full explanation of rights under the Health and Disability Commissioner Act
4. Appendix 1: Complaint Procedures: Detailed process for raising and addressing concerns or complaints
5. Appendix 2: Emergency Contacts: List of emergency contacts and crisis services
6. Appendix 3: Therapy Modality Information: Detailed information about specific therapy approaches used
Healthcare
Mental Health Services
Counseling Services
Social Services
Education
Private Practice
Public Health
Corporate Health Services
Rehabilitation Services
Community Health
Legal
Clinical Operations
Mental Health
Healthcare Administration
Quality Assurance
Compliance
Client Services
Professional Standards
Risk Management
Documentation
Psychologist
Counselor
Psychotherapist
Clinical Social Worker
Mental Health Nurse
Occupational Therapist
Practice Manager
Clinical Director
Healthcare Administrator
Legal Compliance Officer
Quality Assurance Manager
Mental Health Professional
Behavioral Therapist
Family Therapist
Rehabilitation Counselor
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