Statement of Confidentiality Consent 

I understand that this service is a confidential service. No information regarding my attendance or the conversation that takes place will be disclosed to any third party without my agreed, written consent. 
 
Limits to Confidentiality occur in these exceptional circumstances: 
 
Where the therapist believes a client, a child, or another person is at risk. 
Where a serious crime is planned or committed 
Where ordered to by a Court of Law. 
 
I understand that where the client is under 18 years old, parents/guardians herein consent to the therapeutic process and verbal feedback about the child’s progress will be made to the parent/guardian at agreed intervals. 
 
I understand that this service does not issue reports. 
 
I understand that basic notes will be kept. 
 
I understand that appointments will be pre-arranged. Where possible I will inform the service of cancellations at least five working days before the scheduled appointment. I understand that a full fee will apply if an appointment is not attended and has not been cancelled. 
 
I understand that my therapist is bound by the Family Therapy Association of Ireland Code of Ethics, which can be read here. 
This statement will be discussed at the first session. 
 
Parents/Guardians are encouraged to clarify scope of confidentiality regarding the therapist/child conversation 
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