child psychologist Brisbane

Telehealth Consent Form

  • Consent to our Terms and Conditions

    All our services and your use of this website are subject to our Privacy Policy and our Terms and Conditions listed below:
  • 1. Rony Kayrouz or Steve Hansen is your "treating practitioner" responsible for your treatment and 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 psychologist. By signing this agreement you are agreeing to the provision of services under this arrangement

    2. Privacy - Psychodos takes your privacy seriously. We work like a virtual clinic office, collecting and managing personal and medical information digitally from you and your psychologist, 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 psychologists; 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 psychologist 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 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 yourself or other stakeholders e.g. your ex-partner/teacher/caseworker 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. Sessions fees and charges - all session fees are collected via stored credit card in HealthKit or bank transfer or cash at the end of each completed session. Our fees can be found by clicking on this link

    7. Cancellation Policy - If you cancel your first session with less than 24 hours notice, Psychodos will charge you a $65 cancellation fee. This cancellation fee must be paid prior to new appointment bookings. If you wish to cancel or re-schedule an appointment without cost, we require more than 24 hours notice.

    8. The purpose of the psychological therapy session is for you, the client, for therapy use only, and use of video or audio recording is not permitted to be used by the treating practitioner or by the client, for any other purposes, including providing the recording to anyone else in person or on social media". Where it is required, a video, telephone or online (telehealth) consultation may be offered.

    9. The telemedicine solution designed for health practices used in this practice is ZOOM. It is a cloud-based system for video and audio conferencing and no information about the session is saved on the provider’s site and no account is required to use the service. The provider states at least 128-bit AES encryption.

    10. I understand the following: A telehealth consultation will not be exactly the same, and may not be as complete as a face-to-face service and this may affect the psychologist’s ability to respond within my expectations. The capacity for crisis intervention may be diminished. There could be some technical problems that affect the telehealth consultation. The health care service uses systems that comply to recommended Australian standards to protect the privacy and security of the video and telephone consultations. However, the service cannot guarantee total protection against hacking or tapping into the video visit by outsiders including tracking your location. This risk is small, but it does exist.

    11. It is still unclear whether a service delivered over the internet is considered to be from the place where it is provided or the location in which it is received for registration, insurance and legal purposes. If the telehealth consultation does not achieve everything that is needed, then I can choose what to do next. I can change my mind and stop using telehealth consultations at any time, including in the middle of a video or telephone consultation. I will still have the right to ask for and receive health care.

    12. Medicare will be temporarily be allowing rebates and bulk billing for telehealth sessions in 2020 during the Coronavirus crisis. I understand that in many cases a rebate will not be payable for my appointment. This is dependent on the service (Medicare/DVA/private health insurance) and the circumstances (video/ telephone/online mode or emergency circumstances). This will be clear before my appointment.

    I acknowledge that I have read and understood the above conditions and agree to these conditions for any telehealth service provided by my treating practitioner.