Informed Consent

Confidentiality

The information you share in the course of these consultations will be kept confidential. Information will not be shared with your insurance provider, employee assistance provider or any person or organization without your prior knowledge and signed authorized consent.

However, there are limited circumstances where the law requires disclosure. These include situations such as:

  1. threats of violence to self or others;
  2. danger to public safety;
  3. there is information about child abuse, neglect, or when a child is at serious risk of physical or sexual abuse;
  4. If I receive a valid court subpoena;
  5. If there is reason to believe you are operating a motor vehicle in an unsafe manner as described by the Motor Vehicle Act; or
  6. I occasionally consult with colleagues to gain insight to provide quality service. I make every effort to assure confidentiality by not using names or providing details that could lead to identifying the individual who is the subject of the discussion.

Payment

Each session is 50 minutes in length. The fee is $250 for individual consultations, $300 for couple consultations, and payment is due at the end of each consultation or before each consultation. Telephone or Zoom consultations may be arranged between sessions with a 30-minute minimum.

Be advised that there is always some privacy risk with email exchanges and with wireless telephone communication. Please limit email to scheduling or rescheduling of appointments.

The one exception would be the submission of the initial Intake Questionnaire in the event you prefer to email it rather than bring it to the office prior to our initial meeting. There is no charge for the time spent reading your Intake Questionnaire.

Cancellation

48 hours for weekday session cancellations and 72 hours for weekend session cancellations is required. You may notify me of cancellations or rescheduling requests by telephone on 604-358-7287 or via email at sjd@emotionalselfcare.ca. You may be billed for missed appointments if sufficient notice is not received and it is not a medical emergency.

If you have concerns about any interaction between us or about any technique used in the course of consultations, you are urged to discuss these concerns with me. This is a pivotal part of ensuring that you are engaged in a process that empowers you and assists you to claim your own authority.

If you are in crisis and therefore in need of immediate help or someone to talk to when you are between appointments or unable to reach me, please contact your family doctor or go to the nearest hospital. You can also call the Greater Vancouver crisis support line 604-872-3311.

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I have read and understand the statements made in the above Agreement and the Statement of Understanding.

Download to sign (PDF)