Counselling Agreement - LGBT+ Counselling, Support & Awareness

Name of Client(required)

Date of Assessment(required)

Assessors Name:(required)

Your practitioner will always maintain complete confidentiality, with the following possible exceptions: If they have a reasonable concern that you are at risk of being harmed from another person. If they have a reasonable concern that you may be seriously harming yourself. If they have a reasonable concern that you are/may be, harming another. These exceptions all include safeguarding concerns, a safeguarding concern is where there is a concern that somebody is at risk of abuse from someone else. We also have a duty of care to report any acts of terrorism or other serious criminal activity. If any of the above applies your practitioner will be obliged to contact the relevant people/authorities, they will, where possible and appropriate, discuss this with you prior to taking any action but reserve the right to take action without consent if there is a serious risk as outlined above.(required)

Client agreed to this.

As the person sharing your story, you are the expert and as such it is important for you to realise the significance of your contribution in each session. We can only work with what you bring into the session; we will support and encourage you to explore what you would like to; but you need to realise the importance of your contribution. During your sessions we expect you to be open to looking at things from a different perspective. To be aware that sometimes the process of counselling can be a very emotional experience; if you become upset and want to take a pause; we can do this. Please note that we have a zero-tolerance approach to violence, aggression, and any abusive activity towards our volunteers. If this happens we will contact the appropriate authorities and your sessions will come to an end with immediate effect.(required)

Client agreed to this.

Counselling Sessions are a minimum of 50 minutes maximum of 60 minutes and will start and end at the time agreed.(required)

Client agreed to this.

Booking Arrangements

When your counselling session is due to start, if you do not answer the phone or connect the video link or you do not arrive within 10 minutes of the start time; then your session can not proceed. If this occurs and we have not heard from you the session will be recorded as a DNA [Did not attend] Any changes to your appointment must be made with at least 24 hours notice. Any appointments that are not cancelled in time, or not cancelled at all, or otherwise unattended will be recorded as a DNA. These sessions will count as part of your ten sessions and are chargeable. Should you cancel or DNA a total of 3 occasions this will result in automatic discharge. If you are discharged for any reason please note that we will not be able to refund your booking fee. Sessions will not proceed until paid for in full. When attending you must ensure that you are in a confidential space.

Agreement(required)

By signing this agreement the client declares that they have been informed and signposted to and have read our terms and conditions and privacy policy By signing this agreement client declares that they understand and agree to all of the above.

Signature – if you are unable to sign this agreement, please provide a unique password in place of a signature. This password is to be recorded below(required)