Counselling Consent Form

Please read the information below carefully and sign to confirm your consent

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iClient Information

Full Name *

Date of Consent *

1Purpose and Process of Counselling

This counselling process is a collaborative journey between the counsellor and the client, aimed at understanding and restoring psychological, emotional, and relational well-being. The counsellor will listen without judgment and support the client in gaining insight and making positive changes.

2Counsellor Qualifications and Approach

The counsellor is a qualified professional, accredited under both Australian and Korean national standards. An integrative approach is used, incorporating psychological, relational, and spiritual insights as appropriate for the client. Quality of counselling is maintained through regular supervision and professional consultation when necessary.

3Expected Benefits and Limitations

Counselling may help with self-understanding, emotional regulation, and relationship restoration. However, results vary between individuals, and specific outcomes cannot be guaranteed.

4Emotional Reactions During Counselling

During sessions, past memories or emotions may surface, which can temporarily cause discomfort, sadness, anger, or anxiety. These are natural therapeutic responses, and the counsellor will guide the client in processing these emotions safely.

5Confidentiality and Its Exceptions

All counselling sessions are strictly confidential and will not be shared with third parties without the client's consent. However, the counsellor is legally and ethically obligated to report to relevant authorities without prior consent in the following cases:

Clear risk of self-harm or harm to others
Suspected abuse of children, elderly individuals, or people with disabilities
Court orders or other legal requirements

6Personal Information and Record Management

Personal information and counselling records are securely stored and will be retained for a minimum of seven (7) years in accordance with Australian law before safe disposal. Clients may request to access their records, though some restrictions may apply.

7Consent for Session Recording

For the purpose of improving counselling quality, sessions may be recorded with the client's consent. Recordings are kept strictly confidential, securely stored, and will be safely deleted after counselling ends.

I consent to sessions being recorded

8Fees, Payment, and Cancellation Policy

Counselling fees vary by session type and will be provided in advance. All fees are subject to 10% GST.
Payments can be made before or immediately after the session via card or bank transfer.
Cancellations made within 24 hours of the scheduled session or failure to attend may incur a fee.

9Crisis and Emergency Policy

Counselling services are for non-emergency support. If there is any threat to life or an urgent crisis, please contact 000 (Emergency) or Lifeline (13 11 14) immediately.

10Counsellor Supervision and Professional Consultation

The counsellor regularly engages in professional supervision to maintain ethical and professional standards. Any client information used in supervision is de-identified, and personal information is never disclosed externally.

11Withdrawal of Consent and Termination of Counselling

Clients have the right to withdraw from counselling or terminate sessions at any time. The counsellor will respect the client's decision and may provide appropriate referrals if needed.

✍️ Client Signature

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* Signature is required

I have read and fully understood the information above, and I voluntarily consent to participate in counselling.

I have read, understood, and agree to all of the above