Lesley Smyth Psychology $150 session fee payment form

If form is not working or you have any questions please email us at admin@smythpsychology.com

  • Disclaimer and Consent

    All our services and your use of this website are subject to our Privacy Policy and the Terms and Conditions listed below:
  • 1. Lesley Smyth of Smyth Psychology is your "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 - Smyth Psychology takes your privacy seriously. We work like a virtual clinic office, collecting and managing personal and medical information digitally from you and your 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 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. Lesley does not provide reports, treatment summaries etc (other than those she is legally obligated to do). Should there be a need for such a report, referral options can be provided.

    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 practitioner 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 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. Confirming your first appointment booking - To confirm the first session booking, all new clients consent to completing the Claiming, Consent and $50 session fee payment form via the online form and payment portal link that will be emailed to you within 48 hours of receiving the information email. You will have $50 session fee credit will be deducted immediately and your card details stored and securely encrypted within the NAB (National Australia Bank) Transact system for all future session fee payments

    7. Cancellation Policy - Cancellations made with less than 48 hours notice will attract a $50 cancellation fee in the first instance and then the full session fee ($150) will be charged for all subsequent cancellations and be taken off your stored card or you will be required to provide card details to pay for this before another session can be booked. Please be aware that cancellation fees cannot be claimed back from Medicare or private health funds.p/>

    8. The session fee for all of your treating practitioner's services is $150 if this lower concession fee rate has been offered by Lesley. These fees are for every 50 minute session. Longer sessions are charged at a pro‐rata rate. Fees for sessions held outside of the clinic, reports, telephone consultations and home/external visits are available on request. The owed session fee amount will be deducted in full after every session from the stored credit/debit card you provide to us. Payment needs to be received before Medicare rebates of $131.65 or Private Health Invoices are processed. All session fee and cancellation fee payments will be taken via our online payment system NAB Transact after your session being completed. All payments will show up on your credit or debit card statement/online banking with the payment reference 'Changes Psychology Northgate' (NOT Smyth psychology)

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