Agreement, Disclaimer and Waiver Form

Termination of sessions:

Our sessions are a process managed and controlled by you. You can terminate the process at any point in time. If you have scheduled appointments then you must cancel these as per the cancellation policy. The parenting educator has the right to cancel the service provided at anytime, this would be rare and would only occur with a consultation with yourself and as part of referral process to a service more relevant to your needs.

Client responsibilities:

As part of the relationship between client and parenting educator, the client also has responsibilities. In order for your sessions to be of value it is important that you keep the following in mind:

• Keep the parenting educator informed of any relevant treatments you are receiving
• Be as honest as possible with your practitioner
• Respect your parenting educator/ practitioner as a person and as someone who is assisiting you
• Commit to the sessions, actions etc that you and your practitioner decide are required
•  I understand and agree that I am fully responsible for my well-being during my sessions, and subsequently, including my choices and decisions. I understand that the parenting sessions is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment, and I will not use it in place of any form of therapy.

Confidentiality and privacy:

Your practitioner is required to keep all of your personal information private; it won’t be shared with anyone without your prior consent. There are however a number of exceptions to confidentiality, these include:

• When disclosure is required if you report child, elder abuse or neglect by yourself or others – if practitioner has reasonable cause to believe that a child has suffered or currently suffering from abuse or neglect, then as a mandatory reporter I am required to contact Department of communities and Justice and or police.
• Legal requirement to disclose – example ordered by a court to provide information
• To prevent a clear and imminent danger to yourself and others or if you disclose threaten to harm yourself or others – If practitioner has reasonable believe that there is an imminenet danger to the health or safety of the client or any other individual, I may be required to take protective actions. These actions may include notifying the potential victim, contacting the police, seeking hospitilisation for the client or contacting family members or others who can help provide protection. If such a situations arises, I will make every effort fully discuss this with you before taking any action and will disclose information that is absolutely necessary.
• Your records will be kept for a minimum of 5 years in a secure and safe location and will then be destroyed in a manner that protects your privacy
• I understand my practitioner will abide by confidentality and do their best but that the use of technology is not always secure, and I accept the risks of confidentiality in the use of email, text, phone, Zoom, Skype, and other technology.
• When you have written consent for your counsellor to disclose personal information

I understand the necessary actions will be taken, and my confidentiality agreement limited in this capacity.

Cancellation policy:

• Payments must be made prior to sessions. There are no refunds on any sessions/ services purchased.
• Please note that if you forget your appointment, arrive late or give less then 24hours notice of inability to attend, you will be charged 100% of the full fee. If you give less then 48 hours notice, 50% of the fee will be charged as time is being put aside to see you.
• Sessions can be rescheduled for free up to 24hours before the original booking time. All notice of cancellation and or rescheduling must be in writing and delivered by email to info@mindful-parenting.com.au

Coaching Disclaimer and Waiver:

• I understand that all comments and ideas offered by my parenting educator are solely for the purpose of aiding me in achieving my defined goals. I have the ability to give my informed consent, and hereby give such consent to my parenting educator to assist me in achieving such goals and aims.
• I hereby release, waive, acquit, and forever discharge my parenting educator, any agents, successors, assigns, personal representatives, executors, heirs and employees from every claim, suit action, demand or right to compensation for damages I may claim to have or that I may have arising out of acts or omissions by myself or by my parenting educator as a result of the advice given by my parenting educator or otherwise resulting from the parenting educator and client relationship contemplated by this agreement. I further declare and represent that no promise or inducement, or agreement has been made to me to sign this agreement. This agreement shall bind my heirs, executors, personal representatives, successors, assigns, and agents.

All services and communication email or otherwise, delivered by Zahie El Hajj at Mindful Parenting  are meant to help you identify the areas in your life and in your thinking that may be standing in your way. However, our sessions in this context are not specialised professional mental health care or medical care. If you feel psychologically stressed to the point it is interfering with your ability to function, please have the courage to seek the help you need in the form of a mental health professional.

I, Zahie El Hajj confirm that in these sessions I am a certified conscious parenting educator and that all the information given in the sessions is private and confidential and will not be passed by me onto anyone outside of the sessions without written authority from the client. All notes will be filed respsonsibly and securely and will not be accessible to anyone outside of the sessions. There are exceptions to this which have been listed above (refer to confidentiality section in this form)