Voluntary Informed Consent

For Your Security and Confidence

Please complete and submit the form below.

  • I hereby consent to participate in online counselling (telehealth) provided by Perspective Matters Counselling using telecommunication technology.
  • I understand that online counselling involves the use of video conferencing or other remote communication methods.
  • I acknowledge that while online counselling offers convenience and accessibility, it also comes with limitations and risks, including potential disruptions to technology.
  • I understand that Perspective Matters Counselling uses a secure encrypted platform to mitigate these risks to the best of its ability.
  • In the event of technological malfunction or internet disruption occurring during my online counselling session, I understand that Perspective Matters Counselling will email or phone me with instructions on how to reconnect.
  • Confidentiality means that everything we discuss during your online counselling session will be kept private and secure. However, there are times when I may need to share information, like if I'm worried about your safety or if the law requires it.
  • I understand that I have the option to withdraw my consent for telehealth services at any time and may request in-person sessions if available.

Please Note. For clients under 14 and those with a medical condition that limits their ability to understand the nature and purpose of counselling responses, the signed consent of a parent or guardian is required. Please email or phone me for more information.

All fields are compulsory