Only complete this form if you are the client receiving counselling or other services. This contract and consent form cannot be filled out by another person unless they are a legal guardian of a client with full legal rights to advocate and sign on behalf of a client.

Counselling Sessions:Counselling sessions are provided to help you explore and understand all forms of personal issues for your improved health. Sessions are provided to establish meaning and methods of supporting of your mental, emotional, psychological, physical and overall state of being. In the counselling session you are offered a safe and supportive space, and you are able to make decisions about what you wish to explore and discuss, and any goals you wish to pursue. You consent the counsellor may share, provide and apply various additional insights, therapies and support modalities in the interest of health and wellbeing such as, but not limited to, relaxation techniques, mind-body treatment, zone therapy, root cause somatic trauma processing and CBT in an endeavour to provide awareness and build comprehension, skills and capability for you as a client to explore and resolve issues you feel you need to address. You have the right to ask questions and make informed decisions about your participation in all aspects of therapy. The aims of MindBody Healing services are to: support you and whatever choices you make; inform you of choices that are available to you; create a safe environment for you to disclose sensitive and personal information; provide you with tools and options to ensure well-being for you and your whanau, and; to respect your decisions at all times.

The aims of MindBody Healing services are to support you and whatever choices you make, inform you of choices that are available to you, create a safe environment for you to disclose sensitive and personal information, provide you with tools and options to ensure well-being for you and your whanau, and to respect your decision at all times.

Confidentiality: Jason is a member of the New Zealand Association of Counsellors and adheres to their code of ethics. Counselling discussions and notes are confidential. However, if our conversation leads me to believe either you or someone else is at imminent risk of serious harm I may need to let others know. This situation also applies if I believe a child is at risk of harm. Wherever possible, sharing of your information will be discussed with you before disclosure.

Privacy: You consent to MindBody Healing and its counsellor(s) collecting, recording and using non-identifying information to help support and improve counselling and other services.

Session notes: I may take notes of your relative personal circumstances, historical and whanau/family details as well as my observations and your words during sessions, and in some circumstances may write a brief summary of what is talked about. These notes are kept in a secure location. You are able to request to see them at any time. Please do not record any counselling sessions in any way on any form of device.

Supervision of the counsellor: In accordance with the NZAC Code of Ethics I attend regular supervision. Supervision focuses on providing support for my counselling practice with clients and particular issues, and supervisors abide by the same standards for confidentiality. There may arise times where I seek consultation with a supervisor in case of an emergency to maintain the quality of care whilst safeguarding client identity.

Complaints: My goal is to support all aspects of your mental and emotional health, and therefore I actively endeavour to create a safe atmosphere for you to disclose, explore and understand the issues you talk about. You are always in control of the session content and you are always free to advise me of how you are feeling at any time if you do not feel safe. If you have a concern about my practice, I invite you to raise it with me personally face to face, or by phone or email. Formal complaints can also be made through the national counselling association; the process for this can be found on their website on http://www.nzac.org.nz/.

Sessions: Sessions last approximately 45-55 minutes. It is expected that the session will begin at the agreed time. Any session that begins after this time due to late client arrival for whatever reason cannot usually be extended beyond the agreed finish time. If I am not notified by phone call or text within 24 hours of the appointment time starting, this is considered a cancellation.

Cancellations: You are required to provide me with at least 24 hours notice of cancellation for a session if you cannot attend. If for any reason I have to cancel a session I will aim to provide you with 24 hours notice. Prepaid sessions will be carried over to the next available session. Refunds are not provided in these circumstances unless discretion is given by the counsellor. In the event of a legitimate emergency or circumstances out of your control please maintain health and safety as a priority and contact the counsellor as soon as possible afterwards to discuss your circumstances.

Contact between sessions: Calls or text messages can be made to Jason on 022 474 2550. Emails can be send to [email protected]. Text messages are preferred for organising sessions and confirming payment. If I am unable to take your call, please leave a message. Calls and messages will be responded to as time permits between sessions within normal operating hours.

Please note that MindBody Healing is not a crisis service and sometimes there will be a delay before the message is answered. If you need to speak to someone immediately, please contact your GP, or phone or text 1737 to speak to a counsellor 24 hours a day.

If you are experiencing an emergency please call 111.

For further information about how your information is treated confidentially and also utilised for support of MindBody Healing services you can find more information on the terms pages of this website.