Client Registration | Janette Houghton Therapy

Statements of understanding

I understand that all clinical information shared with my therapist will remain confidential EXCEPT where they believe there may be a risk of harm to myself or others, or where there is a legal duty of disclosure.

I understand that my therapist has case supervision with their supervisor where a broad outline of my case may be discussed as part of the supervisory process and that no identifying details will be revealed.

I have read the HGI Information for Clients form (see link above) including the section about use of questionnaires and how the data will be used in service evaluation and research. I understand by selecting the box I am giving permission for my anonymised data to be used for service evaluation and research and that I can withdraw my consent to this at any time by contacting my therapist.

I understand that my personal data will be kept in accordance with the Data Protection legislation. I consent to information about me being held by my therapist to contact me about appointments and treatment or provide helpful information. They will provide me with access to that data held about me if I request it.

I understand that my therapist will not share my personal data with other individuals or organisations EXCEPT where they believe there may be a risk of harm to myself or others, or where there is a legal dut of disclosure.

I understand that my therapist will retain a record of my treatment for a period of 7 years in accordance with professional requirements and will take steps to ensure the accuracy and security of the record.

I give permission for my therapist to put my name and contact details into an online calendar programme which sends out appointment reminders.

I give permission for my therapist to retain an anonymous record of my treatment on specialist therapeutic software.

Janette Houghton Therapy

07731 673070

janette@janettehoughton.co.uk

Client Registration Form

GDPR

Please follow this link for more information about the GDPR

‪https://www.eugdpr.org/

IMPORTANT - Please complete in all cases