Client Agreement

In order to commence counselling with me please read the information below and complete the form at the bottom of the page and press send when finished.

AS A COUNSELLOR

I can offer you online counselling either live, using a private Messenger chat room or by email.

Whichever method you choose the following should be used as the basis for our working agreement.

Emails can be exchanged in two ways.
1. You may want to write to me as often as you like, knowing I will respond to all your E mails on a set day each week (e.g. Thursday.)
2. Or you may want me to respond to each email as I receive it.  I normally reply to E mails within 48 hours and will let you know when this is not possible.

I would like you to indicate which option you prefer later in this Agreement.

My main email response to you I call a Therapeutic Email. I number the emails in a pre-paid package in the subject line as T/E 1/3 or T/ E 1/6 this is the package you pay for.  You may have a query after you have read a T/E and I reply briefly to such queries at no additional
Charge.   Any administrative emails (e.g. to book a live session) are also not charged for.

Live Sessions need to be booked with me in advance by email moiracongreve@hotmail.com
Or   telephone   me on Skype (my call is  Moira 111) this  is a free telephone call if you are also on Skype
Or   0034 922781702 land line 
It normally takes 24 hours to arrange but can sometimes be done quicker do not forget the time in each country I am on British time GMT

Confidentiality
I keep our counselling sessions and records confidential within the framework described on my website   www.lifestyle-choices.com  I work to the Guidelines for Good Practice of my professional body, the British Association for Counselling and Psychotherapy (BACP). You can check my details in BACP’s online directory at www.counselling.co.ukYour identity and personal details will be protected by me and the only exceptions are   when I judge that there is serious risk to yourself or others or when I am compelled to by Law. In the rare event that I break confidentiality, this is done with your prior knowledge if possible and only to people who absolutely need to know (e.g. doctors).I have regular supervision of my online work but I do not disclose your identity to my supervisor.

Referral
it is not always possible to know at the beginning, if working online is the most appropriate   way for you to get   help. If I believed that face to face counselling would be a better   way to help you I would suggest that either we hold face to face sessions or, if this is not possible, I would help you to find a counsellor near to you and support you whilst you make the change to face to face.

Payment
The charges for my counselling services are the ones set out on my website or above in the payment section or agreed prior.
 I will respond to your emails and hold live sessions after I have received notification of payment.

Payment can be made using one of methods below.

•  PayPal: www.paypal.com    

• via my  website: www.lifestyle-choices.com

• Internet Bank Transfer to the Halifax Bank Account Name: Moira Congreve
                 Please contact me for the bank details directly if you choose this method
.                Please add your own name as a reference I can then send a receipt 

• Cheques can be paid direct to the bank payable   to Moira Congreve  over the counter 

• Cash can also be paid over the counter. Again ensure you have your name as reference

Please email me when you have paid so I can monitor the payment. I will reply when it has cleared.

Not far to go now. Below is your agreement to work with me called the client section please fill in and returned to me

CLIENT SECTION of our agreement of working together

Please feel you can ask any questions before completing the blank spaces below and returning the Form to me with your next email.

I have read through and agree I  am over 18 years of age  the information given by me here is accurate to the best of my knowledge .

Basic Details about me

My Name is:

My Telephone number is: (For emergency use in case of serious technology failure)

My Email address is:

Communication
I wish   to communicate with you in the following way:

(Please  select your prefered option, you can always change it later)

• I want to receive email responses on a set day each week (please select)

Monday Tuesday Wednesday Thursday Friday

• I wish to receive an email response to every email I send (please tick this box)

• I wish to have a ‘live’ session via MSNor Skype

( Please indicate the days and times which suit you best.)

Monday Tuesday Wednesday Thursday Friday

10am 12pm 2pm 4pm 6pm

Saturday 11am Saturday 13.00

I will then confirm the time and date with you when your payment has cleared.
 
I will pay via: 

Pay pal
Or I need the bank details sending to me for a bank transfer
Or I will pay a  cheque to Moira Congreve
Or cash to the  bank

The Name of  my GP  is
(Note only contacted with your prior knowledge)

2. Tel. No. of Surgery
(Please include full dialling code)
The date today is

I wish to confirm our agreement and I have read all the terms conditions.

If you have any further questions please email me.

If you do not wish to continue please can you let me know what you liked or did not like about your experience so I can improve the service .

Any questions you have,  please write them  below;

 

 

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