I N F O R M E D   C O N S E N T   F O R   C O U N S E L L I N G

Thank you for choosing Pacific Horizon Therapy. This document provides important information about my professional services and policies. Please read it carefully and ask any questions you may have. Your signature at the end indicates your understanding and consent to these services.

N A T U R E   O F   C O U N S E L L I N G

Counselling is a collaborative process that may involve exploring emotions, thoughts, relationships, and life experiences. At times, this work can feel challenging, but many clients also experience relief, clarity, and growth. You are free to ask questions, request clarification, or pause/stop counselling at any time.

C O N F I D E N T I A L I T Y

Everything you share in counselling is confidential. Information will not be released without your consent except in situations required by law, including:
• If there is risk of harm to yourself or someone else
• If a child or vulnerable adult may be at risk
• If records are subpoenaed by a court
• If required for professional ethical consultation (with identifying details removed)
If you have questions about confidentiality, please ask at any time.

S E S S I O N S   A N D   F E E S

• Sessions are typically 50 minutes unless otherwise arranged.
• The standard fee will be discussed prior to beginning therapy.
• Payment is due at the end of each session unless pre-arranged.
• Receipts are provided for insurance or reimbursement purposes.
• Fees may increase periodically with reasonable notice.

C A N C E L L A T I O N   P O L I C Y

If you need to cancel or reschedule, please provide 24 hours notice. Late cancellations or missed appointments may be billed at the full session rate.

R E C O R D S   A N D   P R I V A C Y

I maintain confidential clinical records according to BCACC and provincial guidelines. Records are securely stored and accessible only to me. You may request to review your record in writing; we can discuss the process if needed.

C O M M U N I C A T I O N

Email, text messaging, and other electronic forms of communication may not be fully secure. These methods should be used primarily for scheduling and practical matters, not for therapeutic content.

In emergencies, please contact:
• Local emergency services (911)
• Crisis Line: 310-6789 (no area code)
• Or go to the nearest hospital emergency department
I do not provide emergency or crisis services.

R I G H T S   A N D   R E S P O N S I B I L I T I E S

As a client, you have the right to:
• Be treated with respect, sensitivity, and professionalism
• Ask questions about any aspect of your therapy
• Decline any technique or intervention
• End counselling at any time

You are responsible for:
• Attending scheduled sessions
• Paying fees as agreed
• Participating in therapy in a way that feels right for you