Psychology Consent Form for New Zealand

Psychology Consent Form Template for New Zealand

A comprehensive consent form designed for psychological services in New Zealand, compliant with the Health Information Privacy Code 2020, Privacy Act 2020, and Health and Disability Commissioner Act 1994. This document establishes the therapeutic relationship between psychologist and client, outlining service terms, confidentiality provisions, client rights, and consent requirements. It includes specific provisions for data protection, record-keeping, and emergency procedures while adhering to New Zealand Psychologists Board Code of Ethics and relevant healthcare legislation.

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What is a Psychology Consent Form?

The Psychology Consent Form is a fundamental document required before the commencement of any psychological services in New Zealand. This document serves multiple purposes: it ensures compliance with New Zealand healthcare legislation, establishes informed consent, and documents the agreement between psychologist and client regarding service provision. The form must be completed prior to initiating psychological services and requires regular review and updates. It includes essential information about service terms, confidentiality, privacy provisions, fee structures, and client rights under New Zealand law. This document is particularly crucial for maintaining professional standards and protecting both client and practitioner interests while ensuring alignment with the Health Information Privacy Code 2020 and the Code of Health and Disability Services Consumers' Rights.

What sections should be included in a Psychology Consent Form?

1. Client Information: Basic identifying information about the client, including name, date of birth, and contact details

2. Psychologist Information: Details of the treating psychologist, their qualifications, and registration number

3. Service Description: Clear explanation of the psychological services being offered, including type of therapy or assessment

4. Confidentiality Statement: Detailed explanation of confidentiality principles and their application

5. Limits of Confidentiality: Specific circumstances where confidentiality might be breached (e.g., risk of harm, legal requirements)

6. Client Rights: Overview of client rights under the Code of Health and Disability Services Consumers' Rights

7. Fees and Cancellation Policy: Clear outline of service costs, payment terms, and cancellation policies

8. Record Keeping: Information about how client records will be maintained and stored

9. Consent Declaration: Formal statement of consent to be signed by the client or their legal guardian

What sections are optional to include in a Psychology Consent Form?

1. Emergency Contact Information: Section for emergency contact details, particularly important for clients with specific risk factors

2. Cultural Considerations: Section addressing specific cultural needs or considerations, particularly relevant for M��ori clients or other cultural groups

3. Electronic Communication Consent: Additional consent for using electronic communications (email, telehealth, etc.)

4. Research Participation: Optional consent for use of anonymous data in research, if applicable

5. Student/Intern Involvement: Consent for student or intern involvement in treatment, if relevant to the practice

6. Audio/Video Recording Consent: Specific consent for any recording of sessions, if applicable

What schedules should be included in a Psychology Consent Form?

1. Fee Schedule: Detailed breakdown of all possible service fees and payment terms

2. Privacy Policy: Detailed privacy policy explaining how personal information is handled

3. Client Rights Information Sheet: Detailed explanation of rights under the Health and Disability Commissioner Act

4. Practice Policies: Detailed practice policies including cancellation, communication, and emergency procedures

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

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What sections are optional to include in a Psychology Consent Form?

What schedules should be included in a Psychology Consent Form?

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