A. Confidentiality

  1. All content shared during therapy or records from this process is considered confidential. Disclosure of any such information requires your verbal/written consent.

  2. There are limitations to confidentiality as stipulated by the Health Professions Council of South Africa (HPCSA), as summarised below (see the Government Gazette for comprehensive details):

    1. If there is imminent danger to self or other the Psychologist has an ethical duty to report this to ensure everyone’s safety and mitigate risk.

    2. If the psychologist is required by law or summoned by court, they are obligated to break confidentiality.

B. Fees

  1. A 50-60 minute session is charged at current medical aid rates, currently R990, longer sessions are charged at a pro-rata rate.

  2. An annual increase in fees will occur, in line with what is recommended for practitioners.

  3. Should a report need to be written as a result of the assessment/therapeutic process this will be charged for at the hourly rate.

  4. Appointments are required to be cancelled 24 hours in advance. Failure to do this means the client is liable for the full amount of the scheduled session. Please note medical aids do not cover missed or late cancelled appointments.

  5. The client/person responsible for the account maintains full responsibility for the invoice, this should be paid within 7 days of receiving the invoice. The client is also responsible for the account should medical aid not settle within 30 days.

  6. Should the client wish to claim from medical aid, he/she gives permission for his/her diagnosis to be disclosed to assist with the claims procedure.

C. Emergencies

Communication to the psychologists cellphone or email address are not appropriate options in the case of an emergency, as she may be unavailable to take the call. Therefore, please contact:

  • SADAG Suicide Crisis helpline: 0800 567 567,
  • Childline: 0800 055 555,
  • Lifeline: 0861 322 322,
  • or visit your local Emergency Centre.

  1. The client/legal guardian of the client understands confidentiality and the limitations as discussed above.

  2. The parties give informed consent for the client to participate in psychological assessment and/or therapy.

  3. The client takes full responsibility for the payment of the account.

Client’s full name:

Client’s signature (if 14 years or older):

Legal Guardian’s Signature:

Date:

From time to time this contract may be updated and published on ClinicalPsy.ch