Data collection
I will collect your name, address, email address, telephone number, date of birth and your GP’s details. I will also collect potentially sensitive data such as physical and mental health issues, medication taken, family details and reasons for counselling.
During sessions I will write down some of the salient points and issues as they arise.
Process and use of this data
All details are restricted to hand-written paper documents which are stored in a locked filing cabinet.
The contact details allow me to contact you during our counselling sessions. I will only share this information with the police or your GP if I believe you to be a significant risk to the lives of others or yourself through stated intent to commit suicide. I am also legally obliged to notify the appropriate authorities regarding terrorist activity or drug money laundering.
The notes regarding sensitive personal details assist me in working appropriately with the issues you bring. I may refer to and discuss the content verbally with my clinical supervisor however your identity will be concealed.
I may share information I hold about you, if requested to by my insurance company, in the event of a complaint made against me.
Disposal of data
I will hold all data in my filing cabinet for a period of 7 years following the end of therapy. All notes will subsequently be destroyed.
Letters to third parties
Where I am requested by a client to write a letter to a third party such as a solicitor, GP or to write an invoice which includes your data, I will delete the files from my computer and keep a hard copy with your client file in my filing cabinet. The laptop I use for writing such letters is for my business use only and is password protected.
Clinical Executor
In the unfortunate event I can no longer work with you due to my sudden sickness or death, I have appointed a clinical executor who will have access to this data to notify you of the situation.
Consent
Please sign below if you
consent to your above details being stored in this way:
Name: ________________________________________
Signed:
________________________________________ Date: ______________________________
(Updated 3rd June 2018)
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