Counselling Consent Form
The purpose of this consent form is to ensure that you are fully informed about our wellness counselling services and to obtain your consent to proceed with counselling.
- Nature of services:
- I understand that Wellaware offers wellness counselling to adults above eighteen (18) years of age, focusing on, but not limited to personal growth, loss and grief, trauma, and crisis.
- I understand that counselling sessions will be held via a secure online platform that may involve risks, including technical issues or unauthorised access. I agree to maintain my privacy during the sessions.
- I understand that counselling is a collaborative process, requiring scheduled attendance, communication, stable internet connection, functioning audio and video, and completion of agreed-upon exercises to ensure my active participation in achieving positive outcomes.
- I understand that Wellaware is committed to providing a safe, supportive, and non-judgmental environment and working with me to address my concerns and goals.
- Confidentiality and limitations
- I understand that all personal information shared during sessions will be kept confidential, except when required by law or when there is a risk of harm to myself or others.
- I understand that confidentiality may be breached in the following circumstances: risk of harm to self or others; suspected child or elder abuse; court-ordered disclosure of information.
- Fees and payments:
- I have been informed of the session fees and payment methods.
- I agree to settle the fees as per the agreed-upon payment schedule.
Protection of Personal Information Act (POPIA)
According to the Protection of Personal Information Act 4 of 2013 (POPIA), Wellaware will ensure that its systems and operations comply with its obligations including all systems onto which data is copied, compiled, collated, processed, transmitted, stored, collected, mined, altered or deleted or otherwise used, and will at all times be of a minimum standard required by Law and be of a standard no less that the standards that are in compliance with the international best practice for the protection, control and use of data.
Wellaware will take all reasonable precautions necessary to ensure that the third party will treat members’ information with the same level of protection as required by Wellaware. Information may be hosted on servers managed by a third-part service provider, which may be located outside of South Africa.