Chandrima Das

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Informed Consent for Telehealth Services Welcome: Before starting, it is important to know what to expect and to understand your rights as well as your commitments. This consent form is intended to be transparent about the process so you are fully informed prior to beginning. What to expect: Psychotherapy, counseling, and coaching involve a process of opening up about your life experiences and your genuine thoughts and feelings to increase self-awareness of psychological and emotional conflicts that may be keeping you stuck in unwanted patterns. It may involve temporary periods of discomfort as you begin to work through past experiences or confront conflicts you have previously been avoiding. Fees: Sessions are billed at the rate listed at the time of booking. Payment terms are set by Chandrima Das. Confidentiality: The information you share during sessions is considered confidential. Chandrima Das cannot reveal to third parties whether or not you are a past or current client, and cannot disclose any information discussed during sessions without first obtaining your consent. In some instances Chandrima Das may be required or permitted to share information without your consent, such as: - If you are deemed to pose a threat of harm to yourself or someone else. - If information shared leads Chandrima Das to believe that a child, elderly person, or disabled person is at risk for abuse, neglect, or exploitation. - If you are under 18, your parents or legal guardians may have access to your records. - If a court of law orders Chandrima Das to release information. Your environment: You are responsible for ensuring you are in a private, safe, and distraction-free location during your session. Chandrima Das cannot guarantee the privacy of your physical environment. Technology: Sessions are conducted over video and depend on a stable internet connection. Neither Chandrima Das nor Therapytips.org is responsible for technical disruptions beyond their control. Notifications: When appointments are scheduled, automatic email reminders will be sent to the email address you used when booking. By agreeing to this consent form, you agree to receive these notifications and understand that email is not a fully confidential medium for transmitting health information. Scope of services: Chandrima Das is qualified to work with a wide variety of clients and concerns, but there may be situations where they are not best positioned to address a particular issue. In these cases, Chandrima Das will work with you to identify appropriate resources. If you are experiencing a mental health crisis or medical emergency, please contact your local emergency services immediately — this service is not a substitute for emergency care. Liability: By agreeing to this form, you consents to the above terms and agrees not to hold Chandrima Das, Therapytips.org, or their affiliates liable for any negative consequences that may arise from their therapeutic journey. you understands that Chandrima Das is an independent professional and that Therapytips.org is a booking platform and not a clinical service provider.