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LWWHC Consent Form 同意表格

Living Without Worry Counselling
and Allied Health

Together, we can do more than we can do alone. Let’s bring our abilities and passions together to affect real change.

There are many ways to join us and support our mission. Contact us to find out more about counselling and NDIS support coordination, fundraising events, and ways that you can get our message to your friends and family.

If you need assistance completing the form phone us on 1300 889 609

LWWHC Consent Form 同意表格

The purpose of this document is to explain important issues that relate to the counselling and supervisory services provided by Living Without Worry Health Clinic. 此文件会对生活无忧健康诊所提供的服务提供重要的解释说明。

Confidentiality: As part of providing a counselling or supervision service I will be required to record and store information related to your circumstances. This is important in order for me to provide a quality service to you. You may request access to your information. I take confidentiality seriously and I will not disclose any information without your permission.

The exceptions to this: a) If required by Australian law or a court order b) Risks to you or others exist due to not disclosing the information 信息保护： 作为心理咨询服务的一部分， 法律和职业标准要求我们对您的信息进行保存。这也是保证我们提供高质量服务的基础。 您可以要求查阅您的信息。 我们严格保守您的信息，不会向任何第三方提供您的信息如果没有您的同意。但是以下属于另外情况 a) 如果澳洲相关法律或者法庭要求 b) 如果不提供您的信息将对您或他人造成严重的危险

Fees: The fee is required by cash or cards at the end of each session if you pay by yourself when you complete the following card section, otherwise we need payments when you book. If an organisation is funding sessions then an invoice will be sent after the session. 费用： 此费用在每个咨询结束后支付如果填写以下付款信息， 否则预约时请付款。如果是公司支付，发票可发给您的公司。

Registration with LWWHC 注册LWWHC: As part of our registration process, we collect the following information:

Personal Details

Date/Month/Year

Payment Information unless pre-arranged otherwise

Cancellation Policy: If you are unable to attend, or you reschedule or cancel your appointment, we require a 48-business-hour notice. Failure to do this will incur the full cost of a session if cancelled within 24 business hours; or $100 if cancelled between 24-48 business hours. Please be aware that most funding does not offer the rebate for any cancellation fees. 咨询取消政策 如果您不能按时参加咨询，或者延迟或者取消咨询，我们需要48工作小时的提前通知。如果不能提前通知，将会产生以下费用：24 工作小时之内通知须付全费；24-48工作小时通知需付100澳元。请注意，取消咨询费用一般说自付费的。
Health Questions(Required)
Have you (or are there any additional people on the premises who have) experienced symptoms of fever, cold or acute respiratory infection in the last 7 days? 健康问题 您或您的共同居住的人有没有发烧，感冒或者急性呼吸道感染的症状在最近的7天里？ 有/ 没有
Consent(Required)
I have read and understand this consent form. I agree the conditions of services provided by Living Without Worry Health Clinic. I consent for Living Without Worry Health Clinic (LWWHC) to collect, store and utilise this personal information for the purposes of providing services for/to me in accordance with the relevant privacy legislation and any other legal requirements that may apply. 我……. 已阅读并理解以上内容。我同意以上生活无忧健康诊所的服务条款。
Must be the client or legal guardian aged 18 or above to sign this form. 名字，签字和日期
DD slash MM slash YYYY

Stories of Growth

Discover the impact of our specialised services first hand as individuals share their transformative experiences in the testimonials section, offering insights into the positive outcomes achieved at Living Without Worry Health Clinic.

  • Living without Worry Clinic provides reliable and highly professional services. With their support, I am back to my social life and on the right track to my mental recovery journey. They support me to increase my NDIS funding, which allows me to have the most appropriate support in my life now.

    – Tommy W.

  • I am extremely happy with the service I have received from Living without Worry Clinic. They understand my situation and support needs with a gentle and warm-hearted approach. Under their professional support, I have dramatically increased my NDIS funding, which better meets my daily mental and physical support needs.

    – Jenny W.

  • I have received friendly, trustworthy and quality services from Living without Worry Clinic. They have improved my mental wellbeing and my life quality as a whole. I highly recommend this service.

    – Jacqueline E.