Consent Form for New Client

As part of providing a quality psychological service to you, the clinical psychologist will carry out ongoing psychological assessment and record personal information about you that is relevant to your current situation. This information will be used to inform any treatment that is carried out.

Purpose of collecting and holding information

Information that is gathered about you as part of your assessment, diagnosis and treatment will be seen only by your treating psychologist (except where legislation requires otherwise – see ‘Confidentiality’).  The information is retained in order to document what happens during sessions, and enables your psychologist to provide a relevant and informed psychological service.

Access to Client Information

At any stage you as a client are entitled to access the information about you that is kept on file, unless the relevant legislation provides otherwise.  The psychologist may discuss with you appropriate forms of access if required.


All personal information gathered by the psychologist during the provision of the psychological service will remain confidential and secure except where:

  1. It is subpoenaed by a court, or
  2. Failure to disclose the information would place you or another person at serious and imminent risk; or
  3. Your prior written approval has been obtained to:
    1. provide a written report to another professional or agency (e.g. GP or lawyer); or
    2. discuss the material with another person (e g. parent or employer); or
  4. Disclosure is otherwise required or authorised by law.

Please Note: If, after reading this Consent Form you are at all unsure of what is written or you have any questions please discuss it with your treating psychologist at your appointment.