child psychologist

Right Brain Psychology $50 payment form

If form is not working or you have any questions please email info@rightbrainpsychology.com.au or call 0477110330

  • 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. Claudia Paretilla of Right Brain Psychology is your "treating psychologist" 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 psychologist. By signing this agreement you are agreeing to the provision of services under this arrangement

    2.Privacy - Right Brain Psychology and Changes Psychology 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 (i.e. Cognitive assessments) or family court related purposes (i.e. no custody reports) 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 your child with your ex-partner/teacher/OT etc, we need written consent from you to approve this sharing of information with each individual. Moreover, if you intend to claim rebates from Medicare or another organisation is paying for the services, then your psychologist must provide summary reports to the referring GP, Paediatrician, Psychiatrist or external agencies regarding you/your child’s treatment progress in order to be able to give back 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 cancel a booked session with less than 24 hours notice, you will be charged a $50 non refundable cancellation fee for your session.

    7. The session fees are $182 per 50 minute session and charged in 15 minute increments beyond one hour. Payment for sessions needs to be received via our NAB payment system and you will pay a $50 deposit before your first session. Payment of the full session amount needs to be payed before Medicare rebates or Private Health Invoices are processed back into your account.

    8. Please note the following limits to confidentiality due to the legalities around duty of care for mental health practitioner in the event of an emergency, immediate risk of harm, or if it is mentioned in session that somebody else is in serious risk of harm. In these cases, our duty of care is to call your emergency contact or the relevant services to protect the well being of yourself or the person mentioned. By agreeing to these terms and conditions you therefore, acknowledge and accept these terms.

    9. I have read and understand the above Consent Form and policies described above. I agree to these conditions for the psychological service provided by the treating psychologist. I certify that the information I have provided is true. I understand that where full liability for psychological services is not accepted by TAC, Workcover, VOCAT, NDIS or similar authority that I am responsible for the payment of outstanding fees.

  • Price: $ 50.00
  • $ 0.00