I will bring two copies of this Privacy Notice to your initial appointment for signature by both of us.
For me to be able to fulfil my responsibilities as a Counsellor I will need to record personal information about you. This information includes your name, address, date of birth, age and contact details.
I will allocate you an identifying code which includes your unique client number and the month and year you made an initial appointment (SG0000/month/year). Under this code I will take notes of ‘assessment information’ including your GP details and relevant medical information. I will also note aspects of your presenting difficulties, personal, professional, social and family history that you choose to share with me.
This information will be retained in separate locations (keeping your name and contact details apart from the assessment notes.) My computer is protected by a password and has a virus protection software installed.
Your contact details will be used to contact you. Other personal data such as your name, address and date of birth will be used to verify your identity if there is a need to contact your GP or a request for access to personal data from yourself or legitimate legal instrument such as a court order.
This personal information will be held securely for a period of 3 years from the date of your final attended counselling session with me. Where it is in our best interests to retain this personal information for a longer period, due to any issues arising out of the work, I will hold this for 7 years from the date of your final attended counselling session with me.
Under normal circumstances I have Clinical Supervision once a month and only use your first name and age. My Clinical Supervisor is also ICO Registered and GDPR Compliant. Your contact details alone will be shared in exceptional circumstances with my Supervisor, Peer Group (two trusted colleagues) if I am incapacitated so that they can contact you to explain the situation. The details of this arrangement are set out in my professional Will.
Information about counselling sessions and our work together
In addition, I will write notes of each therapy session under your unique identifying code. These notes will be brief and a factual record of the session. This set of notes will include any agreements made with you e.g. cancelled sessions, holidays, changes to appointment times or location, appointments with other professionals e.g. your GP or hospital. If I have needed to speak and write to your GP this will also be noted and dated on these notes.
These notes may be shared with my Supervisor or Counselling professional body. I may make information from these notes available to legitimate third parties under the following conditions:
Receipt of a request from you and where the release of the notes is not judged by me as likely to cause you significant harm or harm to another person.
Where there is a specific legal requirement for me to do so.
Where there is an ethical duty for me to do so e.g. to avoid serious harm to yourself or another person, including the safeguarding of children or vulnerable adults.
If you are a LifeWorks client, they request that you sign Consent for me to undertake work with you and share information as appropriate with them. This includes using your allocated LifeWorks number to send my Invoice and Closing Documents to them.
If you are a Bupa client I may need to share some information with them if there is a need to request longer term therapy than their original authorisation. I also need to use your unique pre- authorisation code given to you by Bupa to process my Invoices with them.
Record of contact between us
I will hold your name and telephone number on my mobile phone until our counselling relationship ends and then I will delete it from my contact list. I only hold texts whilst they are relevant e.g. sent by either of us in connection with your appointments.
My mobile phone is a smart phone and could therefore have your email address on it. The phone is password protected and details are stored in ‘the cloud’ so they can be restored if my phone is lost or stolen.
You have the right to ask to see information held by me about you. To do this please either ask me or submit a request in writing. You also have the right to ask for information which you believe to be incorrect and rectified. I will endeavour to provide you with the information requested within 4 weeks. If I become aware of a situation where your personal information may have accidentally or maliciously been obtained by a third party I will notify you within three working days, if this is feasible.
If you are concerned about the way that your information is being held please discuss it with me. If you are still unhappy you have the right to complain to the Information Commissioner’s Office www.ico.org.uk I confirm that I am registered with the ICO.
Please sign this page to indicate that we have discussed and agreed how your personal information will be held for the purpose of counselling. Without your agreement to my holding your personal information it will not be possible to proceed with counselling.
Stella Goddard, BA (Hons)
Registered MBACP (Accred)
Counsellor Counsellor Signature……………………………………
Client Name……………………………. ………….. Client Signature………………………………………………