Obtaining an informed consent form is necessary to ensure that you
are aware of the treatment being offered. Since each individual
reacts differently to therapy, it is not possible to predict all
risks and reactions.
By submitting this informed consent form: I understand that the
treatments being provided to me or the person named below for whom I
am legally responsible to may include:
- Traditional talk therapy
- Counselling
- Relationship/marriage counselling
- Professional (work related) counselling
- Sex therapy
And I hereby request and consent to the performance of the above
treatments on me.
I also understand that a session lasts 45 to 90 minutes and
follow-up sessions will be recommended after the first initial
visit. For effective recovery it is advised to have 6-9 visits,
depending on the client need.
I am aware of the risks outlined above and have discussed any
concerns I may have regarding my therapy. I do not expect the
counsellor to be able to anticipate and explain all possible risks
and complications of treatment, and I wish to rely on the counsellor
to exercise judgement during the course of treatment which they
think at the time, based upon the facts then known is in my best
interest. I understand results are not guaranteed.
I am consenting to the treatments offered by Catherine Holden or by
her fellow counsellors and to treatments recommended by them as
well. I have been told about the risks and have had an opportunity
to ask questions.
Since e-mail is not a totally confidential means of communication,
please consider this as you communicate with us. While we will make
a reasonable effort to keep what is written private, it is suggested
that very personal information be communicated by phone, on paper,
or in person.
If you are experiencing a life-threatening emergency, please call
emergency services (999/112/911) immediately. If this occurs during
out of office hours, and is not an emergency, please contact the
therapist during office hours.
Cancellations
Cancellation is free, if done 24 hours in advance of the
appointment. Please contact us through e-mail
or by phone (+254 713 896 905) to do so. We request that you also
provide feedback on why you have cancelled.
Rescheduling your appointment
If you wish to reschedule your appointment to an alternative date,
please contact us at least 24 hours before appointment time through
e-mail (info@almondtreewellness.co.ke) or by phone (+254 713 896
905). You may reschedule an original appointment twice, after which
your initial visit fee will be forfeited.
The information contained in this form is confidential. It is
intended solely for counsellor.
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