• You have the right to decline any activity or request and to stop therapy session at any time.
• You have the right to ask for a referral to another therapist or care-provider.
• You also have the right to access the information I keep in my clinical records that pertain to you – a right that continues after therapy ends.
• You have the right to withdraw consent for the collection, use, or disclosure of personal information, except where precluded by law.
• You have the right to review your progress and any topics discussed on this form.

Although we do not direct-bill insurance providers, many extended medical plans cover therapy sessions with a Registered Psychologist in Alberta. You may be covered directly or through a health spending account. Please check with your provider.

If you cannot attend your scheduled appointment, please provide at least 24 hours’ notice.

A full-session fee is charged both for missed appointments and for cancellations with less than 24-hour notice.

If you feel uncomfortable with any aspect of your assessment or therapy, I encourage you to share your concerns with me. If you find that discussion is not possible, feels unsafe, or fails to resolve your concerns, you may contact the College of Alberta Psychologists (1-800-659-0857).