This is to inform you what data I am collecting from you and what I intend to do with it.
- What data do I keep and why do I need it?
- Name and age – this is basic information that helps me get to know you.
- Address, email address, phone number – I use this as a way of contacting you regarding your sessions. I will mainly use the method you first contacted me on but if I cannot reach you, I will try a different method.
- Next of kin/medical professional’s details – If I was worried that you were at risk then I may need to contact your next of kin or medical professional, if I can. I will let you know when/if I am going to do this.
- Session notes – I keep brief notes of our session(s), and they are kept in a secure folder in my office and on my computer.
- Will I share your data and if I do, who will I share it with and for what purpose? It is very unlikely that I will share your data. I will not sell it on or use it for unethical reasons. I may have to share it if my notes are subpoenaed by court, if you or anyone you tell me about is at harm or risk of harm, I may have to pass this information on. I may also discuss your case during supervision but I only use your first name.
- How will I store your data? Example text: It is mainly stored as hard copy in a locked filing cabinet. Immediately after the work is finished, I transfer the data with your initials to my password protected computer. Your phone number(s) may be kept in my business mobile phone with your first name and last initial. Only I will access your information.
- How long will I store your data for and how will I dispose of it? I will keep your details and session notes for the time required by my insurer (currently 7). After this time, I will destroy any document with your personal information and delete your phone number out of my mobile phone.
- Consent Do you consent to me using your data in this way? Please write Yes or No
- Name of Therapist:
- Signature of Therapist
A Printable PDF version is available on the book now tab .