Forging Paths – Coaching, Counselling, EMDR Therapy, Supervision

Agreement for Psychotherapy

Please read the following agreement that includes important information about the processing of your data. Kindly tick the consent box and fill in the necessary details. This agreement will be sent to Michael Conti as an email and will be stored as your consent form. A copy of it will also be automatically sent to the email you specify at the bottom.

This is an agreement between Michael Conti and the client as indicated below.

1. SERVICE PROVIDER
2. Storage of personal data
  • The minimal amount of information is kept about you in order to deliver my services in an ethical and legal manner. All information about you is stored securely electronically or in a locked physical location. Any notes about the work we are doing together is stored separately in anonymised form. Some of your details are stored on software platforms that are used for us to be able to deliver our services (e.g. email, invoicing software, calendars) and they also have data processing agreements. I will do my utmost to ensure that the platforms we use are secure. However, I am not in any way liable for any breach in data processing by such platforms.
3. Accessing your data
  • You can access your data by sending a written request to myself. If you disagree with the content of the notes, a discussion will be held regarding the changes and, if agreed, I will change these upon receipt of a written request to do so. If an agreement is not reached regarding the change (e.g. you request false information to be included), you will need to request me to delete your records (point 4).
4. Deletion of data
  • Any email correspondence is deleted immediately after it no longer serves the purpose (e.g. rescheduling of appointments) or after our work together is concluded. Personal notes are kept for 5 years from the end of the quarter (March, June, September, December) when our work together ends, after which all digital or physical records are destroyed securely. Financial record-keeping will be deleted according to legal requirements.
  • If you wish for your personal information to be deleted before the end of the abovementioned 5 years, a written request needs to be submitted to myself.
  • Hardcopies of any written requests or consent forms, including this form, are held securely for 10 years.
5. Communication
  • Communication regarding the setting up of appointments will be conducted via e-mail or text-messages. These will be deleted after the scheduled appointment.
  • Online sessions will be held using a secure video-conferencing platform.
6. Confidentiality
  • Everything disclosed during our work together is treated confidentially and I do not disclose personal information to third parties unless ordered to by the Court. You can require personal information to be passed on to a third party upon written request addressed to myself.
  • In case of criminal activity or reasonable risk of serious harm to self or others, I may choose, or have, to breach confidentiality. In case of risk of harm, the usual contact person is the emergency contact provided by yourself. Whenever possible, I will only involve others after having discussing this with you.
  • Except for your personal details, dates of appointments and financial documents, I do not communicate any personally sensitive material via e-mail or text messages. I am not responsible for what happens to any personal information you choose to disclose over e-mail or text messages.
  • Material that comes up in our work together can, at times, be discussed confidentially with a supervisor or mentor who are also bound to confidentiality. The aim of this is to ensure the best professional quality of the service being provided. This is standard ethical and professional practice and your anonymity is maintained throughout.
7. Cancellation of sessions
  • If you need to cancel a session that we scheduled, it is important to inform me at least 48 hours before the beginning of the session. Please understand that late cancellation results in the session being booked for you and so would need to be paid in full. In case of reasonable medical reasons, this notice period can be waivered.
8. Complaints
  • If you feel that you have been treated unethically by myself, you are free to complain to a professional body we are a member of. More information can be found on the Imprint page at: https://forgingpaths.net/imprint.