Disclaimer and Consent

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. Our Service - You (or your child) will be receiving services from a Clinical Psychologist who holds postgraduate qualifications and is registered with AHPRA. As part of treatment, if the client is a child/teen you (the parent/guardian) may be involved where appropriate. The psychologist may also participate in regular professional supervision and peer consultation to ensure high-quality care. During these sessions, de-identified client information may be shared. Your confidentiality is fully protected in these instances. Services are offered both in person and via Telehealth (video or phone). Telehealth consultations are subject to the same privacy and confidentiality standards as in-person sessions.

4. Fees and Rebates - The standard session fee for a 50-minute consultation is $220. Longer sessions are charged pro-rata. Additional fees for reports, phone consultations, or external visits are available on request. All session fees are processed after each session using the secure NAB Transact system. Medicare rebates or Private Health Insurance claims will be processed only after payment is received. Fees may vary if a concession rate has been agreed upon. Sessions are available both in person and via Telehealth. Telehealth sessions are billed at the same rate and eligible for Medicare rebates when applicable. For sessions where a parent attends without the child present, up to two Medicare rebates may be used from the child’s referral. Your card details are securely stored and encrypted through NAB Transact. Payments will appear on your card statement under "Changes Psychology Northgate."

5. Confirming Your First Appointment - To confirm your first appointment, new clients must complete the online consent and payment form. A $50 session fee credit will be charged and held. This amount is deducted from the cost of your first session.

6. Cancellations - Cancellations made with less than 48 hours' notice will incur a $50 cancellation fee for the first occurrence. Subsequent late cancellations will incur the full session fee ($220). All fees will be processed via NAB Transact. Cancellation fees cannot be claimed from Medicare or private health funds. Repeated late cancellations or missed sessions may affect your ongoing care.

I have read and understood the above information and the Privacy Policy. I consent to: • Participating in psychological sessions. • Sharing of de-identified information in peer supervision. • Use of AI software for confidential notetaking. • Communication with my GP and relevant agencies for care coordination. • The administrative role of Changes Psychology in booking and payment services. • Receiving services in person or via Telehealth. • Payment of all applicable fees and compliance with the cancellation policy. I understand that I may withdraw consent or stop attending sessions at any time.