- I hereby give my unqualified and unconditional consent for the therapist to appropriately deal with physical sensations/Thoughts and Emotions which may emerge in the therapy session/s including any catharsis experienced by me. I also agree to the therapy sessions with me being tape recorded. I agree to above conditions on the therapist maintaining a strict confidentiality about above information and information revealed during my therapy sessions/s. It is a understood that without my written permission no aspect of my therapy sessions will be revealed to anyone whatsoever.
- I agree that my case details may be shared by the therapist with his/her supervisors for training purpose/s but with no other person / entity without my written permissions.
- I waive my right to confidentiality for information to be given to medical and law and order authorities if in the opinion of the therapist before, during and after the therapy sessions, he/she perceives a physical / mental threat to client or any other person due to any mental and/or physical conditions of the client.
- I also agree to hold the therapist indemnified against all direct and third party claims which may arise from undertaking of therapy sessions with the client.