Confidentiality Information & Agreement Form

Counselling is a confidential process designed to help you address your concerns, come to a greater understanding of yourself, and learn effective personal and interpersonal coping strategies. It involves a relationship between you and a trained counsellor who has the desire and willingness to help you accomplish your individual goals. Counselling involves sharing sensitive, personal, and private information that may at times be distressing. During the course of counselling, there may be periods of increased anxiety or confusion. The outcome of counselling is often positive; however, the level of satisfaction for any individual is not predictable.

CONFIDENTIALITY:
All interactions with Julia Rose Counselling, including scheduling of or attendance at appointments, content of your sessions, progress in counselling, and your records are confidential. You may request in writing that Julia Rose Counselling release specific information about your counselling to persons you designate.

EXCEPTIONS TO CONFIDENTIALITY:

• If there is evidence of clear and imminent danger of harm to self and/or others, a counsellor is legally required to report this information to the authorities responsible for ensuring safety.
• A court order, issued by a judge, may require Julia Rose Counselling to release information contained in records and/or require a therapist to testify in a court hearing.

We appreciate prompt attendance to appointments. Please notify us if you will be late. A twenty-four hour notice period of cancellation allows us to use the time for others.