Consent Form

RENEE MEGGS

Registered Psychologist
Focused Solutions
Counselling and Coaching

 

CONSENT FOR TREATMENT

FOR COUPLE’S COUNSELLING

 

 

    Confidentiality:
    There are three circumstances in which Renée Meggs legally has to share the information you share with her:
        1.If you are planning to kill yourself imminently.
        2.If you are planning to hurt someone else and that includes children.
        3.If you are involved in court and my files are subpoenaed.

    Limits to Confidentiality and other informed consent discussions (We will discuss this together):


    Fees:
    Renée charges $1999 for the 10-hour retreat.
    I understand the purpose and nature of these services, which has been explained to me by Renée Meggs, Registered Psychologist of Focused Solutions Counselling and Coaching.

    Dated this day of 20