General Intake Form

Welcome

Welcome to RK Counselling & Psychology.

We provide evidence-based counselling and psychological services for individuals, couples, and families. This document outlines important information about our services, your rights, and our responsibilities so you can make an informed decision about engaging in therapy.

Please read this carefully and ask any questions before proceeding.

Nature of Service

• Sessions are typically 60 minutes unless otherwise agreed.
• Therapy is a collaborative process aimed at supporting your wellbeing.
• While many clients experience benefit, outcomes cannot be guaranteed.
• You may ask questions, request changes, or withdraw from services at any time.

Fees & Payments

• A deposit may be required to secure your appointment.
• Full payment is required prior to the session unless otherwise arranged.
• Additional time beyond your scheduled session may be charged at a pro-rata rate.
• Outstanding balances must be finalised before future appointments.

Appointments & Cancellations

Appointments are reserved specifically for you.

• Cancellations or reschedules within 4 days incur a $100 fee.
• Cancellations within 48 hours incur the full session fee.
• Non-attendance is charged at the full session rate.

By proceeding with a booking, you acknowledge and agree to this policy.

Confidentiality

Your personal information and session content are treated as confidential.

Confidentiality may be limited where:

• There is a serious risk of harm to yourself or others
• There are concerns relating to abuse or neglect
• Disclosure is required or authorised by law (for example, a court subpoena)

Where possible, this will be discussed with you prior to disclosure.

Privacy & Information Handling

We collect personal and health information to provide counselling and psychological services.

Your information is:

• Stored securely and accessed only by authorised practitioners
• Used for care, communication, and administration
• Handled in accordance with privacy legislation

Information may be disclosed:

• With your consent
• Where there is a serious risk to your safety or others
• Where required by law

We use secure systems, including clinical documentation tools and AI-assisted note-taking where applicable. You may withdraw consent to the use of these tools at any time.

You have the right to request access to or correction of your information.

Full details are available in our Privacy Policy:
https://www.rkct.com.au/privacypolicy

Use of Technology (Including AI)

• Secure clinical tools may be used to support documentation
• Only necessary clinical information is retained
• Data is handled in accordance with privacy laws
• You may opt out at any time
• You may ask which tools are being used

Telehealth

If you engage in telehealth services:

• There may be limitations to privacy, security, and connectivity
• You are responsible for being in a private and safe location
• Your practitioner may confirm your location at the start of each session

Communication

Communication outside of sessions (such as email or SMS) is for administrative purposes only and must be directed to the practice, not your practitioner.

Therapeutic support is not provided outside of sessions. Messages are not monitored continuously and response times may vary.

Crisis & Emergency

RK Counselling & Psychology is not a crisis service.

If you require immediate support, contact:

• Emergency Services: 000
• Lifeline: 13 11 14
• Suicide Call Back Service: 1300 659 467
• 1800 RESPECT: 1800 737 732

Practitioner Model

Each practitioner is responsible for their own clinical decision-making and delivery of services, while working within the policies and standards of the practice.

Psychology Clients (if applicable)

Where relevant, you consent to communication between your practitioner and other health professionals (such as your GP, psychiatrist, or referrer) to support coordinated care.

You may withdraw or limit this consent at any time.

Complaints

If you have concerns about your care, you are encouraged to raise them with your practitioner or the practice.

You may also contact:

• Australian Counselling Association (ACA)
• Psychotherapy and Counselling Federation of Australia (PACFA)
• Psychology Board of Australia (via AHPRA)

Informed Consent

By proceeding, you confirm that you:

• Have read and understood this information
• Have had the opportunity to ask questions
• Understand the nature and purpose of the service
• Understand the limits of confidentiality
• Understand the cancellation and payment policies
• Understand how your information is collected and used
• Understand your rights, including access to records and withdrawal of consent
• Consent to receiving counselling or psychological services