Confidentiality: What we discuss is confidential and remains privileged information. I will not release information about you without your informed and written consent, except in the following circumstances:

• If a child (under the age of 16 or 16-17 and in the care of child welfare) may have been harmed in the past, or that a child is at risk of harm in the present or future, I have a duty to report this.
• If there is risk of harm to yourself or others.
• If I am required by law to do so, such as a court subpoena.
• If I am bound by law to report a regulated health professional for professional misconduct.
• If an individual becomes incapacitated and I need to contact a family member, friend or substitute decision maker.
• To demonstrate my competency under the regulated Social Work and Social Service Work
Act (1998), I may be required to share file information.

Informed consent: Entering into psychotherapy is a deeply personal event that comes with its own risks and benefits. For example, while you may feel distress or become more aware of upsetting thoughts, this may lead to a sought-after healthier lifestyle or better decisions. Understanding my approach to psychotherapy, establishing goals, and reviewing them from time to time is essential.

Privacy of personal information: I take notes to help me keep track of the issues that arise during the course of our work together. These comprise mostly your words and are kept in a locked and secure location for a minimum of 10 years. I have a duty to protect the collection, use and disclosure of this information, which is by law considered your "personal health information". When it is time for your records to be destroyed, I will do so in a secure way that protects your confidentiality.

Videoconferencing: I offer online psychotherapy. This is a relatively new way of conducting psychotherapy and while there is good evidence to support its usefulness and benefits, there are associated risks and challenges. Risks include the fact that the technology may be compromised, unresponsive and slow at times. Benefits include not having to travel and more efficient use of time.

While most insurance companies have provided coverage for virtual psychotherapy for a number of years, it’s always best to check with your provider. The software I use is encrypted in order to protect your privacy and meet provincial requirements for personal health information.

There are a number of things you can do on your end to ensure your privacy:

• Ensure that the device you use is private and you have shut off any other possible ways for someone else to connect, such as Bluetooth device that connects in a shared car.
• When we connect, ensure that you are in a private room. If someone else is present, you must tell me and they will need to be on camera.
• If for some reason our technology fails, I will telephone you at the number specified above.
• Neither you nor I may make audio or visual recordings of a session without mutual and legal consent.

Business hours: I keep Monday to Friday business hours. I do my best to respond to telephone messages, emails and text messages within 24 hours. With regard to email and text, I ask that you do not send me any personal health/history information through this medium for security reasons. Texts and emails are accepted to confirm an appointment time or to request resource information.

Cancellation of appointments: I require twenty-four (24) hours’ notice via text, email, phone or voicemail or I will be obliged to charge you for the missed appointment.

Professional fees: Individual session costs $135 per hour. Couple/family session costs $150 (a 50-minute conversation plus 10 minutes' administration). This includes time spent for consultation on the telephone. Payment is due at the end of each session and can be made by cash, cheque or electronic bank transfers. I do offer sliding scale fee. If you are interested in discussing this, please let me know.

Your rights as a client receiving psychotherapy services: I am committed to providing psychotherapeutic services in a professional, respectful and ethical manner. I would encourage you to discuss with me any concerns you may have in the delivery of this service. The Ontario College of Social Workers and Social Service Workers regulates the services I provide for you.

By signing below you agree that you have received and that you understand the above-stated information.