All therapist’s communications, records and contracts with clients and professional and support staff will be held in strict confidence.

Clinical Progress Notes may be released, in accordance with the law, only when:

1. The client signs a written release of information indicating informed consent to such release;

2. The client expresses serious intent to harm himself/herself or someone else;

3. There is evidence or reasonable suspicion of abuse of a minor, an elderly person (sixty-five years or older), or a dependent adult; or

4. A court order is received directing disclosure of information.

Hypno-Psychotherapy notes are the property of the therapist and will be retained in strict confidence without release to any party. It is our policy to assert (a) a privileged communication in the event of #4. Although we cannot guarantee it, we will endeavour to apprise clients of all mandated disclosure.

By signing below I acknowledge that I have read and understood the above confidentiality policy. If you are in agreement with the foregoing, complete this form and indicate your acceptance below.