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 & reactions.
By submitting this informed consent form I understand that the treatments being provided to me may include:
- Cognitive Behavioral Therapy
- Rational Emotive Behavior Therapy
- Motivational Therapy
- Relationship Therapy
- Couples Therapy
- Sex Therapy
- Work-Related Therapy
And I hereby request & consent to the performance of the above treatments on me. All therapy sessions are conducted online.
I also understand that a session lasts 60 to 90 min & follow-up sessions will be recommended after the first initial visit. For effective recovery it is advised to have 6-9 sessions, depending on client need, presenting concerns and recommended treatment plan. Working on yourself (or your relationship) outside the therapy space, doing the homework and going through any suggested readings, doing your own reflections, utilizing worksheets and resources provided by the therapist are also important and recommended to get the full benefit out of psychotherapy.
I am aware of the information outlined above & have discussed any concerns I may have regarding my therapy. I do not expect the therapist to be able to anticipate & explain all possible risks & complications of treatment, & I wish to rely on the therapist 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 Dr. Catherine Holden and I have been informed about the risks, benefits & have had an opportunity to ask questions. Dr. Catherine Holden may also recommend other specialists that I can work with to receive holistic care and treatment.
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.
If you are experiencing a life-threatening emergency, please call emergency services (999/112/911) immediately. If this occurs during out-of-office hours, & is not an emergency, please contact the therapist during office hours.
Payment
I will need to pay 100% on booking for my session.
An appointment will not be confirmed without payment and can be cancelled (without notice) if I do not make payment within 2 hours of making this booking.
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. Also, please refer to your payment receipt for more information.
Rescheduling your appointment
If you wish to reschedule your appointment to an alternative date, please contact us 24 hours before your appointment time through e-mail or by phone (+254 713 896 905). You may reschedule an original appointment once, after which 100% of the fee will be retained.
Illness on the day of your appointment
If
you are unwell on the day of your session, your session can be rebooked to another day to allow you to heal and recover.
24 hour notice period
If you do not give 24-hour notice when cancelling or rescheduling an appointment, you will be charged the full session rate - thank you for understanding that Dr Catherine Holden's professional time is set aside just for you.
The information contained in this form is confidential. It is intended solely for the therapist.
By booking an appointment, you are agreeing to the terms and conditions explained above.
