Privacy and Confidentiality
As part of providing a psychological service (including but not limited to assessment, diagnosis and treatment) to you, Walk Different will need to collect and record personal information from you that is relevant to your current situation. This information will be a necessary part of the psychological assessment and treatment that is conducted. You do not have to give all your personal information, but if you don’t, this may mean the psychological service may not be able to be provided to you.
Purpose of collecting and holding information
The information is gathered as part of the assessment, diagnosis and treatment of the client’s condition and is seen only by the psychologist. The information is retained in order to document what happens during sessions, and enables the psychologist to provide a relevant and informed psychological service.
Access to Client Information
At any stage you as a client are entitled to access to the information about you kept on file, unless the relevant legislation provides otherwise. The psychologist may discuss with you appropriate forms of access.
All personal information gathered by the psychologist during the provision of the psychological service will remain confidential and secure except where:
It is subpoenaed by a court, or Failure to disclose the information would place you or another person at serious and imminent risk; or
Your prior approval has been obtained to
a) provide a written report to another professional or agency. eg. a GP or a lawyer; or
b) discuss the material with another person, eg. a parent or employer;
c) or if disclosure is otherwise required or authorised by law.
As Walk different is a service conducted in the outdoors there is a chance that you will run into someone that you know. This is handled in the same manner of this occurring in a waiting room or office situation.
Charter for Clients of Psychologists
A copy of the Charter for Clients explains your rights as a client of a psychologist. This can be accessed here
I desire to engage voluntarily in the walking program organised by Walk Different. I understand that I will be walking and sitting as part of my Walk Different session. I also understand that on some occasions I could run into someone I know. I understand that I am responsible for monitoring my own condition throughout the session and should any unusual symptoms occur, I will cease my participation and inform the staff of the symptoms.
In agreeing with this consent form, I affirm that I have read, accept and understand this form in its entirety and that I understand the nature of exercise. I know that there may be risks associated with the Walk Different session and willingly accept those possibilities. I know that it is my responsibility to ensure my own safety. I take full responsibility for my own health and safety in participating in the session and to the extent I deem advisable, will consult a physician before participating. I agree to pay all reasonable costs related to the Walk Different Session, including any medical costs I incur.
In consideration for being allowed to participate in this activity, which I do freely and voluntarily for my own personal benefit, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assigns to:
1. Waive, release and discharge from any and all liability to Walk Different, their elected and appointed officials, employees, students, agents, and volunteers for my death, disability, personal injury, property damage, or property theft, or actions of any kind which may hereafter accrue to me.
2. Indemnify and hold harmless Walk Different, their elected and appointed officials, employees, students, agents, and volunteers, from any and all liabilities or claims made by other individuals or entities as a result of or relating to my participation in this activity. Therefore, intending to be bound and as a condition of being allowed to participate in the Walk Different session, I have freely agreed to this waiver on the date indicated.