Dear Client, as per your request for online therapy, following is your informed consent form. Please go through it.
Minds Cheq maintains full confidentailty. Information shared between the client (you) & the therapist (assigned therapist) during all your sessions shall remain confidential unless you indicate to them that you plan to harm yourself, or harm somebody else. In which case, after informing you, the therapist will have to notify a psychiatrist or other appropriate authorities (parents/guardians) to ensure yours/others’ safety. The therapist will not be liable for any breaches of confidentiality caused by the client’s error.
The relationship between you & the therapist will be strictly professional. For the therapy to be effective, please do not share any personal or social relationships outside of therapy
Sessions will be conducted via audio call or video call on Zoom/Gmeet. Technical difficulties, audio/video lag or disconnections may appear, please keep patience and we will soon connect with you. Personal phone calls between the client & therapist are prohibited.
Each session will be for 50-60 mins. A confirmation email shall be sent to your email ID or whatsapp prior to the appointment.
The fee for each session is mentioned depending on your requirement which is 1000/per session for counselling or therapy and 1500 per consult for psychiatrist session. Payment shall be made via online Bank Transfer / Google Pay / UPI / Debit or Credit Cards. The payment must be made at the time of your appointment form.
In case the session needs to be cancelled/rescheduled, the client must do so a minimum of 12 hours prior. A no-show/ inability to meet the conditions will inflict a penalty of 100% of the amount payable for the therapy session.
I understand the terms and conditions by Minds Cheq with respect to a session with a psychologist/psychiatrist. By signing this consent, I agree to abide by its content. I may withdraw from treatment at any time by notifying the Minds Cheq team and the concerned professional. I have enrolled myself for a therapy session with Minds Cheq on my own accord and voluntary will. Minds Cheq team will not be held responsible in case of any extremities like harm to self or others.
