Counselling Agreement

This is an agreement between the client and Wendy Hayes.


1. The Client accepts that the session does not promise the alleviation of the Client’s condition. 

2. In consideration of Wendy providing the counselling service the client agrees:

  • The counsellor will be paid the sum of $100.00 per hour or part thereof for the counselling service provided;
  • If the client makes an appointment and fails to attend the appointment the counsellor will be entitled to be paid for the session unless the client gave more than 24 hours notice of his/her inability to attend the session.

3. The Client accepts the risks involved in counselling and therapy and if anything in the Client’s situation or circumstances changes in a way that will impact on the potential risks of counselling, the Client will undertake to inform my counsellor immediately.

4. Any information provided by the Client to the Counsellor during the counselling sessions (“the information”) will be kept confidential unless:

  • The session records are subpoenaed for Court proceedings; or 
  • The counsellor suspects the Client intends to harm him/herself or others; or 
  • The Client discloses information to the Counsellor concerning child abuse; or 
  • The Counsellor passes on information to a supervising counsellor; or 
  • The Counsellor is otherwise required to pass on the information by operation of law. 

Signed as an agreement by the Client and the Counsellor.

By putting your name on this form you are agreeing to the above conditions.