Emergency Contact Information.

The contact information you provide here is required for safe working practices. It will be sent to my email and stored in a password protected file, the email will be deleted. As part of the confidentiality agreement, this information will not be shared with anyone unless there is the possibility of a risk of harm to you, or to someone else, in which case the emergency services and/ or your GP may be contacted.

This is extremely rare and I will always endeavour to obtain your consent before taking any action.

Professional regulations and legal commitments require the collection of current client contact information for my clinical will. Clinical wills ensure that you are contactable by my professional executor in the event of me being unable to work due to incapacity or death. All information is held securely according to GDPR and the Data Protection Act 2018 and will be deleted upon you ending therapy.

If you have any concerns about the use or storage of your information, or you prefer to fill out a paper copy please let me know at your next session or you can email me at: hello@therapywithchantal.com

This form also asks if you have read and understood the terms of engagement which should have been sent to you, they can also be found here: www.therapywithchantal.com/terms-of-engagement-aug26

If you prefer to fill out a hard copy please let me know.