Informed Consent to Services

This document outlines the counselling agreement between us. It is intended to support you in receiving the care you are seeking, and to affirm your right to understand the nature, benefits, and potential risks of this service.If you are seeking counselling for yourself and you are an adult (age 19 years and over in B.C.), then I require your informed consent indicating that you have read and fully understood its contents.Please carefully consider the terms of this contract and feel free to discuss any of the agreements with me. It is important to understand that I will only provide services to you following obtaining your informed consent, which includes an understanding of your rights, and the benefits and risks associated with these services.By consenting to this contract, you and I will have agreed to fully participate in the services described unless we mutually agree to revise, or add to, any of the provisions, or until you choose to terminate the service. If you decide at any time to not receive services from me, I am happy to provide you with the names of other qualified professionals.You should know that a counsellor is not a physician, and I cannot prescribe or provide you with any medication, medical advice, or perform any medical procedures.Payment & Dāna दानThis counselling offering is grounded in the Buddhist principle of Dāna—generosity freely given. Rather than charging a fixed fee, I invite you to offer what feels sincere and appropriate based on your means and values.Dāna is not a euphemism for "pay what you want" or “by donation”. It is an intentional practice of generosity. Just as I offer this time with presence and care, you are invited to meet it with your own capacity for generosity, honesty, and appreciation.Thus, I do not require a set amount for the session. However, for transparency:$155 is my standard fee for a 50-minute session, based on my professional association’s guidelines.If that is beyond your means, consider offering the equivalent of one hour of your own labour—whatever that looks like for you.If money is tight, offer what feels possible. Your presence and sincerity matter more than the amount.Dāna can be given before or after your session. You’ll receive a link after the session with simple instructions for offering online, or you may donate here in advance.Thank you for supporting this alternative model of care.Cancellation PolicyIf you need to cancel or reschedule, please provide at least 48 hours' notice by email. This allows the space to be offered to someone else who may need it.If you do not show up for your appointment, I will wait for 10 minutes, assuming that you may be running late. After that, the session will be considered missed. Illness and sudden emergencies are certainly understood; however, if you miss a session due to illness or sudden emergency, you will need to wait until the following week's sessions are open (i.e. you will not receive priority booking over other patrons).For sessions cancelled with less than 48 hours notice, or if you do not attend your appointment, I ask that you offer a dāna of $75 (half of my private practice fee) in recognition of the time that was held for you.As an act of mutual generosity, this dana will be donated to causes that support mental health, healing, or Buddhist practice—a way to pass on the benefit of what was offered.Benefits of CounsellingCounselling may help you develop new insights into the issues you’re facing, as well as new skills and strategies to respond to them. Counselling can help a person to develop new skills and to change behaviour patterns, and to become better self-regulated. Counselling can contribute to improved ability to cope with stress and difficult situations, and can increase understanding of self and others, thus allowing you to experience more satisfaction from those relationships.Risks of CounsellingIt is important to understand that there is no guarantee of a successful outcome from counselling and that there are some risks, such as experiencing unpleasant memories and/or difficult thoughts and emotions, such as fear, anger, anxiety, depression, frustration, and loneliness. I often ask you to be aware of bodily sensations, emotions, and thoughts. This can be challenging and can initially lead to some discomfort. Counselling will likely involve trying out new behaviours and changing ways of relating to others. One possible risk is that some others may be challenged to accommodate a stronger, more self-confident version of yourself, and may not be accepting of the changes you are making.Voluntary Participation and EndingYour participation in this service is voluntary. You may refuse to engage in any activity or modality, to ignore any advice and end your involvement or withdraw consent at any point and for any reason.Your RecordPlease be aware that I do keep records of our meetings as per the regulations of my professional association. I do write notes after our sessions, which become the basis of your record. If you would like at any time to see what I am writing, please feel free to ask me.Emails also become part of your record. If you have any questions about your record, its contents, or how it is used by me, please ask at any time. You have the right to access the information in your record, or to obtain a copy of the records.In general, information in your record will only be disclosed to others with your written consent, but there are exceptions. For these, please see the section below on “Confidentiality”.ConfidentialityIn general, the information obtained during the process of counselling is confidential and will only be released to others with your explicit written consent.You understand that as part of routine practice I engage in peer consultation with colleagues. Our work together and relationship may be discussed in this context, and that if I consult regarding your situation it is for the purpose of benefiting my clients. Your name and identifying or detailed information regarding your situation will not be shared.There are legal limits to confidentiality when I must report concerns to the appropriate person and/or agencies. You should understand this prior to sharing personal information with me in a counselling session.These include (but may not be limited to):• You or any other person or an animal is at risk of being abused or neglected, for example, when someone is hurting a child or not giving them what they need to live and be safe.• You tell me that you or another person plan to cause serious harm or death to themselves, or to someone else, and I have reasonable grounds to suspect that you or they have the ability to carry out this threat in the near future.• A person has a condition which makes it dangerous to drive, and keeps on driving even though it’s too dangerous (as per the Motor Vehicle Act).• A court orders that information and reports in my files be released to the court. This could potentially occur if for any reason you are or become involved in a legal case.• A person tells me about the behaviour of a health professional which might cause danger or harm to them or someone else if it is not stopped.If you elect to engage in telephone or virtual video counselling sessions with me, I guarantee that I will conduct our settings within the privacy of my home, without interruption. You are solely responsible for ensuring that the time and location at which you engage in telephone or video sessions is conducive to confidentiality, and you assume all liability to this effect.Data SecurityWhile I take all reasonable steps to safeguard my data and use encrypted software that is fully compliant with the Personal Information Protection and Electronic Documents Act (PIPEDA), please be aware that if you agree to email communications between us, or you elect to choose telephone or virtual video sessions, these forms of communication can never be guaranteed to be 100% secure.Email errors are common, and your workplace may monitor employees’ use of the internet or email. If others have access to your email account, you have the option of setting up a code word or phrase so that I know you are the author of any particular email message.Emails may also be kept on a server. Also, records will exist of such communications between us on my computer/device as well as on yours, and from a privacy perspective I encourage you to treat this information in the same way as you would your personal health records.By consenting to this document, you voluntarily assume the risks inherent in these forms of electronic communication.ContactI do not provide counselling or consultation by email. If it is a crisis or emergency you are experiencing, you understand that it may be best for you to call your family doctor or go to the nearest hospital emergency room.Contract AgreementYou have carefully reviewed this document and have had sufficient time to consider it. You understand this document in its entirety and agree to its contents and to abide by its terms of service. You have had the opportunity to ask any questions or concerns arising from it, and understand that you can ask any questions throughout your counselling.
Any services you receive will be specific to your situation and needs, and while I will make every effort to answer any questions related to your treatment, I may at the outset not be able to answer all the specifics. If you wish to stop counselling at any time, all you have to do is tell me. However, if you do at any time wish to stop, I would ask that we have an opportunity to meet to discuss this rather than just no longer coming to counselling.Based on this information you hereby give your fully informed consent to participate in counselling.