Confidentiality Agreement
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Thank you for considering us during this difficult time. Your discussions with your counseling therapist will focus on your thoughts, feelings, and behaviors related to how you interact with your circumstances, yourself, and others. These discussions aim to bring relief to your situation and help you overcome your challenges. All information shared, noted, and recorded by Daniel will remain confidential within the counseling session, adhering to the guidelines of the registering bodies (CAP and BCACC, the regulatory bodies he works with). Consultation may occur between Daniel and relevant other professionals bound by existing confidentiality agreements to ensure the best possible treatment for you.
The following are exceptions to confidentiality:
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1. when disclosure is required to prevent clear and imminent danger to the client or others
2. when legal requirements demand that confidential material be revealed
3. when a child needs protection.
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You may not record sessions unless I provide you with written permission before the session. Beyond this restriction, the client is free to discuss the content of their counseling sessions with anyone, at any time. The confidentiality of the sessions, except for what is specified in this document, is at your discretion.
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Teletherapy
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Online sessions are conducted via the Zoom platform, which uses unique meeting IDs and passcodes. My computer and file system is protected by firewalls and Norton security. Despite these precautions, electronically transmitted information may still be vulnerable to leakage. If I become aware of a threat to your confidentiality, I will promptly assess the situation with pertinent professionals and inform all relevant parties, including affected clients and the professional associations with which I am registered for oversight and guidance.
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Each of my sessions are audio and video recorded and transcribed, using the Zoom program, to ensure complete and detailed documentation. In-person sessions are not video recorded, but still audio recorded and transcribed. Online sessions are fully recorded by default. If you prefer not to have video recordings of your sessions, please indicate this at the start of "My Story" and submit your preference when ready. The full contents of these sessions are accessible under the supervision of Dr. Randy Johnson, PhD, who is my supervisor in the Registered Provisional Psychologist program with the College of Alberta Psychologists.
My clients may request these recordings for their personal use at any time. However, once I provide the link to the cloud file where the recordings can be viewed, I will not be able to safeguard the content shared with you, as you and unknown others, may access this information through your access without my knowing it. As a result, the client will be solely responsible for the content they request access from me.
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Communication
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No mobile information will be shared with third parties/affiliates for marketing/promotional purposes.
By typing in your name, you are agreeing to participating in sessions under the conditions stated above in this Confidentiality Agreement with Freedom & Hope Counselling & Therapeutic Services
Liability Waiver Form
Freedom & Hope Counselling and Therapeutic Services (FHCTS) is committed to aiding and supporting those in mental/emotional distress. Our primary goal is to lead an individual or couple into better living, and a deeper relationship with themselves and with others. The nature of this process will often mean difficult emotional issues must be confronted. By signing this document, the signee acknowledges that “positive” change is not guaranteed by FHCTS, and that change is the sole responsibility of the client, as they move towards a positive outcome in counselling.
I also acknowledge that I understand that FHCTS will not force change in my life, nor do they guarantee improvement. I acknowledge that the process of finding freedom and gaining hope requires facing fears, hurts and wounding’s from the past - which cause emotional distress in the present, carry into the future until the healing is completed. Such distress is expected in psychological counselling where confusion and deeply entrenched emotional pain are revealed. I acknowledge that cognitive and emotional distress revealed in counselling is my responsibility alone and not caused by FHCTS or any of its members or contributors. I understand that my health, happiness, and healing are my own responsibility, and it is my choice as to how I will deal with the difficult issues brought to light during counselling. I understand I am free to end the therapeutic relationship with FHCTS at any time. I understand that it is my sole responsibility to manage want I do not want to, or cannot face. To the degree FHCTS and I progress in Counselling / Therapy, is the degree I have chosen.
By typing in your name, you are agreeing to the details of this Liability Waiver Agreement with Freedom & Hope Counselling & Therapeutic Services
Fees
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Individual "hour" long sessions are $240.00 and Couples or Family's sessions are one and a half hours in length, with the fee of $360.00.
Booking
Please book with me through the "Contact Me" tab. Please give me a 3 ranges of days and times of those days that you would be available to meet with me, and I will get back to you with one of those days and time, with a booking. If this is your first session with me, I will send you out information as to what I need for that session, give you directions on how you can find my clinic office - if you chose to see me in person, and instructions as to how your session fees are to be paid.
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If you wish to pay by credit card, download my Credit Card Payment Information form at Site Directory | FHCTS.ca, Quick Access, and then Forms, fill out and send back to me at danielfhcts@outlook.com. I will make payment for you for your session the morning of the session. If you choose to pay for your session through e-transfer, please submit your payment at least 48 hours before your session, sending it to danielfhcts@outlook.com. If I do not receive the payment 24 hours prior to the session, the session will be cancelled.
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Any payments made for scheduled appointments are fully refundable if you cancel your appointment more than 48 hours before the session. Rescheduling sessions between 24-48 hours prior to the original booking time will incur no extra cost. If you encounter difficulty attending your appointment on the day of your session and wish to move it to another time on that day, please contact us by email or text. I will make every effort to accommodate you if my schedule permits. However, if I am unable to do so, your booked session will proceed as planned, whether or not you attend.
Cancelled appointments within 24 hours or no-shows will be charged the full session amount, except in exceptional circumstances.
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Receipting
Typically, receipts are issued every weekend. If you require another arrangement, please talk to me about this.
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Session Length
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Please be aware that each "hour" session lasts for 50 minutes. This time allows me to take notes about your session and prepare for the next one, unless I choose otherwise. Sessions may occasionally run longer, especially if the client finds it challenging to recover from discussing difficult subjects. If this occurs, I will inform you of the additional fee (based on your current rate, rounded to the nearest 15-minute mark) and provide you with an email for e-transfer payment within 24 hours of the session ending.
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​You may be eligible for rate reductions of up to 75% based on your household income, equity, and special circumstances. If you are interested in this option, we suggest discussing it with your chosen therapist before booking your session. Clients on a reduced rate must stay in communication, adhere to the agreed-upon schedule, and attend sessions as agreed. Failure to comply will result in the loss of any rate reduction allowances granted by FHCTS.
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Regarding insurance coverage, Daniel is a Registered Provisional Psychologist and a Registered Clinical Counsellor, which are accepted by most insurance plans.
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By submitting this form, I confirm that I fully agree with the terms and conditions of the Confidentiality Agreement, the Liability Waiver, and the Payment Policy. I affirm that I am the person identified in this form and that I am seeking a working alliance with Freedom & Hope Counselling & Therapeutic Services. This agreement will remain in effect as long as I am a client with them.
