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MINDMOKSH's CLIENT CONSENT

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IMPORTANT:  KINDLY READ & UNDERSTAND COMPLETE INFORMATION MENTIONED BELOW.

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[Following text is applicable for BOTH TYPE of sessions conducted: ONLINE & OFFLINE]

 

COUNSELING is a confidential process designed to help you address your concerns, come to a greater understanding of yourself, and learn effective personal and interpersonal coping strategies.  It involves a relationship between you and a trained therapist who has the desire and willingness to help you accomplish your individual goals.  Counseling involves sharing sensitive, personal, and private information that may at times be distressing.  During the course of counseling, there may be periods of increased anxiety or confusion.  The outcome of counseling is often positive; however, the level of satisfaction for any individual is not predictable.  Your therapist is available to support you throughout the counseling process.

 

 

CONFIDENTIALITY: 

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All interactions with Counseling Services, including scheduling or attendance at appointments, content of your sessions, progress in counseling, and your records are confidential.  No record of counseling is contained in any academic, educational, or job placement file.  In case of sessions conducted under CCTV surveillances; be assured that only video footage are recorded & not audio.  

 

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EXCEPTIONS TO CONFIDENTIALITY:

 

•     The counseling staff works as a team. Your therapist may consult with other counseling staff to provide the best possible care. These consultations are for professional and training purposes.

•    If there is evidence of clear and imminent danger of harm to self and/or others, a therapist is legally required to report this information to the personnel/ authorities responsible for ensuring safety.

•    If Counseling Services learn of, or strongly suspect, physical or sexual abuse or neglect of any person under 18 years of age; it is required to report this information to the child protection services.

•     A court order, issued by a judge, may require the Counseling Services staff to release information contained in records and/or require a therapist to testify in a court hearing.

 

 

SESSIONS & FEES:

 

  • Number of Sessions, Types of Sessions, Duration & Fees vary as per the services & actual proceedings during sessions.  M/s. Psymoksh Healthcare Pvt. Ltd. holds complete rights to modify schedule & prices without prior notice.  However, best efforts will be made to convey the changes (if any), before starting of the next consecutive session.

  • For all sessions, PREPAYMENT IS MANDATORY, with certain exceptions.

  • NO REFUNDS ARE PROVIDED.  However, rescheduling of a session is allowed only ONCE with prior intimation.

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PACKAGES:

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  • The bulk booking packages for Individual & Couple Counseling, cover 10 sessions only.  For more sessions, additional charges will be applied accordingly. 

  • Charges of Tests will be different, wherever applicable.

  • A package is valid for the duration of Six (6) months from the date of payment confirmation.

  • Complete payment is mandatory before beginning of the first session in the package.

  • Other Terms mentioned above in 'Sessions & Fees' category are applicable to the Packages as well.

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LAW: 

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This document & any other documentation regarding your engagement with MindMoksh, AND other Terms & conditions shall be governed by and construed in accordance with the Indian Laws.  Any dispute arising out of above text content &/or other terms and conditions shall be subject to the exclusive jurisdiction of Thane, Maharashtra, INDIA.

 

 

Last but not the least, prompt log in/ arrival for appointments is appreciated.  Please notify us if you are going to be late.  Twenty-four-hour notice of rescheduling allows us to use the time-slot for other clients.

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Client Details for Consent

Marital/ Relationship Status
Preferred Language During Session
Have You Taken Any Psychological Counseling or Therapy Before?

Thank You for providing the details!

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