The purpose of this Consent for a Psychological Telehealth Service form, is to inform you about the process of Telehealth therapy services. This form is provided in addition to our regular Client Intake form.
Telehealth is a form of psychological consultation provided via videoconferencing, or via telephone, and can include assessment, treatment and transfer of information or education. It is an effective alternative to regular face-to-face consultations, and can be helpful to ensure continuity of care at times when the provision of therapy by regular means is disrupted.
Telehealth can be provided through various online platforms (in addition to telephone) which can be discussed with your psychologist. You will need to familiarise yourself with the technology needed if you and your psychologist choose to use a videoconferencing platform. Please be aware that you are responsible for any data or call usage costs associated with your Telehealth service.
To conduct Telehealth consultations you will need access to a quiet, private space; and an appropriate device, i.e. telephone, smartphone, iPad, laptop/desktop computer (with a camera, microphone and speakers); and a reliable broadband internet connection.
Please be aware that the privacy of any form of communication via the internet is potentially vulnerable and limited by the security of the technology used. To support the security of your personal information this practice recommends the use of the videoconferencing tool, Health Direct, which is compliant with the Australian standards for online security and encryption. This platform can instantly be accessed via a button on the landing page of the Sutherland Shire Psychology website (SutherlandShirePsychology.com.au).
A Telehealth consultation may be subject to limitations such as an unstable network connection which may affect the quality of the psychology session. In addition, there may be some circumstances for which Telehealth is not suitable. Your psychologist will let you know if they have any concerns about the appropriateness of Telehealth sessions for your situation.
If there is ever disruption to videoconferencing services or technical difficulties, your psychologist will call you on your nominated telephone number to discuss how to proceed with the session. Please note that your psychologist will also contact you by telephone if they are initially having difficulty making contact with you via the nominated videoconferencing platform.
Regular fees apply to Telehealth sessions, and all clients with a Mental Health Care Plan are eligible for a Medicare rebate after full payment of fees to Sutherland Shire Psychology.
Alternately, in the absence of a Mental Health Care Plan, you may be able to claim a rebate from your private health insurer after full payment is made to Sutherland Shire Psychology if certain criteria are met (e.g. your policy covers psychology Telehealth services).
If you need to cancel or postpone your appointment, please give our reception at least 48 hours notice, or you may be required to pay a cancellation fee.
Please read our Terms of Service thoroughly before proceeding.
I have read the Terms of Service provided on this site.
I consent to receiving Psychological Services via Telehealth
I have been provided with information about the Telehealth service including the limitations to privacy and confidentiality, along with technology and billing requirements.
I have read and understood the information in this Consent Form and have discussed any outstanding questions with reception/my psychologist. I hereby give consent to receive psychological Telehealth services from my psychologist, and for the reception to process my payment and/or Medicare rebate at the time of the appointment