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Therapy Consent Form for New Zealand

Therapy Consent Form Template for New Zealand

A comprehensive legal document designed for the New Zealand healthcare context that establishes the therapeutic relationship between a mental health professional and their client. The form ensures compliance with New Zealand's Health and Disability Commissioner Act 1994, Privacy Act 2020, and relevant healthcare legislation while documenting informed consent for therapy services. It outlines the terms of service, confidentiality obligations, client rights, payment terms, and emergency procedures, providing legal protection for both the practitioner and client while ensuring transparent communication about the therapeutic process.

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Therapy Consent Form

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What is a Therapy Consent Form?

The Therapy Consent Form is a fundamental document required in New Zealand's mental health and counseling practices to establish and document informed consent for therapeutic services. It serves as a legal agreement between mental health professionals and their clients, ensuring compliance with the Health and Disability Commissioner Act 1994, Privacy Act 2020, and relevant healthcare regulations. This document should be used before commencing any therapeutic relationship, whether in private practice, healthcare institutions, or community services. It includes essential information about the nature of therapy, client rights, confidentiality provisions, session details, payment terms, and emergency procedures. The form is designed to protect both the practitioner and client while fostering transparency and trust in the therapeutic relationship.

What sections should be included in a Therapy Consent Form?

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

What sections are optional to include in a Therapy Consent Form?

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

What schedules should be included in a Therapy Consent Form?

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

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok成人版 | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

New Zealand

Document Type

Consent Form

Sector

Personal

Cost

Free to use
Relevant legal definitions






























Clauses




















Relevant Industries

Healthcare

Mental Health Services

Counseling Services

Social Services

Education

Private Practice

Public Health

Corporate Health Services

Rehabilitation Services

Community Health

Relevant Teams

Legal

Clinical Operations

Mental Health

Healthcare Administration

Quality Assurance

Compliance

Client Services

Professional Standards

Risk Management

Documentation

Relevant Roles

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

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks, 聽Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination, 聽Severance Pay, Governing Law, Entire Agreemen

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