1. Agreed parties - Matthew Ferriman of Foresight Clinical and Forensic Psychology is your "treating practitioner" responsible for your care, you are "the client" (yourself or the child or adolescent you are organising services for), and Changes Psychology is the admin and billing service "provider" that is only responsible for processing clients' bookings, billing and client administration only on behalf of your treating practitioner. By signing this agreement you are agreeing to the provision of services under this arrangement
2.Privacy - Foresight Clinical and Forensic Psychology takes your privacy seriously. We work like a virtual clinic office, collecting and managing personal and medical information digitally from you and your treating practitioner, which naturally includes sensitive health information. We collect, use and (where appropriate) store this information, which includes health information, in order to facilitate appointments with treating practitioners; manage payment, medicare and insurance claims; and manage records regarding your appointments. We manage your information in accordance with our ethical guidelines. For more about privacy, and who to contact if you have questions or complaints regarding privacy, see our Privacy Policy
3. Your treating practitioner will not provide information, reports or documentation for medico-legal or family court related purposes unless required to by law, under a subpoena or by a court order.
4. Parenting plans - if there is a parenting plan in place we require the parent or person engaging the treatment to meet the all requirements of the plan, it is not our responsibility to share information with other parents or stakeholders.
5. Information sharing - If you would like the psychologist to share and collect information about your child with your ex-partner/teacher/OT etc, we need written consent from you to approve this sharing of information with each individual. However if you intend to claim rebates from Medicare or another organisation is paying for the services, then your treating practitioner must provide summary reports to the referring GP, Paediatrician, Psychiatrist or external agencies regarding your treatment progress in order to be able to give you Medicare rebates and meet the legal obligations of this funding. By agreeing to these terms and conditions you agree to this information sharing policy.
6. Cancellation Policy - If you wish to cancel or re-schedule an appointment without cost, we require at least 24 hours notice. Session bookings cancelled with less than 24 hours notice of the appointment time, or no shows, will attract in a cancellation fee and retain deposit or authorise debiting of your credit card).
7. Confirming sessions and punctuality - it is your responsibility to confirm SMS appointment reminders and to ensure you are aware of and keep scheduled session times saved in your calendar. It is also your responsibility to attend session on time as you if you arrive late the consultation will still finish at the same scheduled time.
8. Unless agreed to with your treating psychologist, initial appointments are 80 minutes and charged at $330. All subsequent sessions are $220 per 50 minute session. All sessions are payable using the card you will provide for the $50 deposit ($50 session fee credit) at the end of this form. Session fees will increase periodically to cover increased practice costs. Foresight Clinical and Forensic Psychology DOES NOT Bulk Bill clients. All clients must pay for sessions via stored card before a Medicare rebate can be processed for them. Direct deposit is not a payment option.
