CLIENT CONFIDENTIALITY AND CANCELLATION FORM
A standard counselling session is 45 minutes to an hour. Payment is required in full after you have attended your appointment and will be invoiced to you or your arranged funding provider. This therapy is voluntary and you may terminate your session at any time. Equine assisted therapy may involve riding but is mainly focused on mindfulness techniques and on you becoming more aware of your own thoughts, feelings and sensations whether you are mounted or doing ground work with the horses.
Save as set out below, all interactions with Racing Hearts are private and confidential and will not be revealed to other persons or agencies without your written permission, except when mandated by state and federal laws, by Court order, or if there is a genuine and reasonable concern for your safety or for the safety of others.
Racing Hearts therapists are required to engage in professional supervision to ensure best quality practice and it may be necessary to discuss your case with other consultants (ideally on an anonymous basis). Please ask your therapist about confidentiality if you would like to know more.
Please note: Confidentiality may be breached if your therapist reasonably considers that you may be at risk of harming yourself or others (or if a sufficient level of abuse is thought to be involved). However, every effort will otherwise be made to respect your privacy.
At Racing Hearts, we understand that situations may arise where you may need to cancel or re-schedule your appointment. Please provide at least 24 hours’ notice of cancellation or re-scheduling so that we can accommodate another client in your place.
Please note that if you do not show up to your appointment or provide at least 24 hours’ notice of your inability to attend as scheduled, a cancellation fee of 100% of your full session charge will be payable on the basis that turning up on time and as scheduled is entirely your responsibility. This is in line with NDIS cancellation guidelines. If you arrive late for your session, we will still be required to end the session at the usual scheduled time to ensure that no other client is inconvenienced.
Your signature (or your parent/guardian’s signature if you are under 18) indicates that you have read and understood this form and that you have had sufficient opportunity to ask any questions and have any concerns that you may have adequately addressed: