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Signs of Abundance

Counselling Online Consent Form 

This consent form is designed to help you feel informed, supported, and comfortable before beginning counselling with Tara J Clarke at Signs of Abundance Counselling, Hypnosis and Healing. It is important that this form is read, understood, and completed prior to your first counselling session (intake session).

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Please know there is no pressure to complete everything immediately. If you would prefer to go through this form together with Tara during your intake session, that is completely okay and will be respected. Many people choose to complete the form beforehand so there is more time during the session to focus on what has brought them to counselling and the support they are seeking. You are welcome to choose whichever option feels most comfortable and supportive for you.

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This form applies to both:

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  • online counselling sessions, and

  • in-person counselling sessions at Palm Cove, Cairns.

Please carefully read all information and complete all sections of this form honestly and accurately.

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By completing and submitting this form, you confirm that:

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  • you have read and understood the information contained in this document

  • you have had the opportunity to ask questions if needed

  • you understand the counselling process, confidentiality, and cancellation policies

  • you voluntarily consent to participate in counselling services provided by Tara J Clarke at Signs of Abundance

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If you are booking an online session, this completed form serves as your online consent.

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If you are booking an in-person session at Palm Cove, this completed form also serves as your in-person consent.

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By pressing the SUBMIT button at the end of this form, you are providing your informed consent and agreement to the terms and conditions outlined in this document. If there is anything you are unsure of, please reach out or bring it up at the first counselling session (your intake session). 

PLEASE READ ALL OF THE FOLLOWING AND ANSWER THE QUESTIONS AS TRUTHFULLY AS POSSIBLE

Health Declaration

Please fill out the following form in order to participate in our counselling with Signs of Abundance.

Have you been hospitalized in the last 12 months?
Are you suffering from a medical condition, illness, or injury?
Please confirm 'yes' that you are not suicidal. If you are suicidal, please call 000 and contact your nearest Psychiatrist or Health professional in your area. If you are not suicidal, please tick 'yes' for yes, I am not suicidal.
Do you have epilepsy, heart problems or any medical condition that may require a support person to be in the background of your session at all times? If so, you must provide a support person in the background or in the next room and provide a phone number to Tara to call this support person if required. If you do not require this support person to be on standby, choose 'no'.
If we lose our online connection, please contact Tara J Clarke immediately or keep your phone on and wait for her to reach out. We will reschedule and continue the session at a convenient time. Do you understand the steps to take in case of disconnection?

Thanks for submitting! 

Client Consent Form for Holistic Counselling at Signs of Abundance Hypnosis and Healing

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By continuing with one or more holistic counselling sessions with Signs of Abundance Hypnosis and Healing, I, the undersigned, hereby give my consent and agree to the following terms:

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  1. Purpose of Consultation: I understand that the consultation is designed to gather information for clinical purposes to formulate customized treatment plans aimed at achieving my desired therapeutic outcomes.

  2. Confidentiality of Health Information: I acknowledge that my health information will be recorded in a secure medical file. This information will not be released to any third parties unless I provide explicit consent or as required by law.

  3. Inter-Provider Communication: I consent to the sharing and discussion of my health information amongst other healthcare providers involved in my treatment, as necessary for my medical support.

  4. Accuracy of Information: I affirm that I have completed the intake form prior to consultation and that all information provided is honest, accurate, current, and true.

  5. Disclosure of Medical Conditions: I agree to fully disclose any and all medical conditions and medical history, including any changes to my personal or health details, to my therapist.

  6. No Guarantees of Results: I understand that results from the counselling sessions may vary and are not guaranteed.

  7. Access to Information: I confirm that I have read or will read the information regarding consultation, assessment, and treatment available under the "Consultation" menu on EHA's website, ensuring I am informed of my consultation, treatment, therapeutic objectives, and outcome goals.

  8. Emergency Contact Consent: In the event of an emergency or other significant situations, I consent to the release of my medical information to my designated contact support person as listed in my intake form.

  9. Consent to Treatment: By signing this form, I provide my consent to participate in Holistic Mental Health Counselling Consultation and Customised Treatment Plan. I understand that this may include additional services offered by Signs of Abundance Hypnosis and Healing, such as meditation, hypnosis, or holistic therapies including Past Life Therapy and Inner Child Therapy.

  10. Right to Withdraw: I understand that I have the right to terminate any session or treatment plan at my own discretion if I feel uncomfortable at any point.

  11. Mandatory Reporting: I acknowledge that if I ever express thoughts of self-harm or harm to others, Tara J Clarke of Signs of Abundance has a legal obligation to report this to the appropriate authorities.

  12. Mental Competence: I affirm that I am of sound mind and capable of understanding the contents of this consent form.

  13. By continuing with the Health Declaration Online Form below, I am agreeing to all of these mentioned terms and conditions.

  14. If you have a medical condition such as epilepsy or a heart problem that could lead to an emergency during an online session, you must arrange for a support person to be nearby—either in the same room or in an adjacent room—so Tara can reach them quickly if needed. This support person should be attentive and available on their phone during your session in case of disconnection. You acknowledge that a support person is only necessary if you have a medical issue that requires urgent assistance. If you do not have such a medical condition, having a support person present is not required.

  15.  We kindly ask that you provide 48 hours' notice if you need to cancel or reschedule your session. This notice period allows us to offer your time slot to other clients. Unfortunately, if less than 48 hours' notice is given, we won’t be able to issue a refund, as we may have turned away others who needed that time. However, if you do provide 48 hours' notice, we will happily reschedule your session to a new date within the next two months. Thank you for your understanding!

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