IN-PERSON CONSENT FORM

BEFORE YOUR FIRST IN-PERSON SESSION, YOU'LL BE ASKED TO COMPLETE A CONSENT FORM JUST LIKE THE ONE BELOW:

This In-Person Counselling Consent contains important information about the decision to resume in-person services in light of the COVID-19 public health crisis.  In order to resume in-person sessions, you must complete this consent.  This agreement supplements the general informed consent agreement that we agreed to at the start of our work together.

 

Decision to Meet Face-to-Face

You and your therapist have agreed to meet in person for some or all future sessions.  Arbour has opened its physical office to in-person counselling on the basis of the BC Health Officer directives and WorkSafeBC best-practice guidelines.  You understand that the continuation of in-person sessions is contingent upon these directives and guidelines, and if they change, we may need to begin or resume remote counselling sessions.

You understand that by coming to the office, you are assuming the heightened risk of exposure to COVID-19.

You understand that access to our waiting room, kitchenette, and bathroom will be restricted, and you will adhere to the posted movement protocols to safely move through our office space.  You understand that some of the therapy room setups  require a plexiglass shield to meet distancing guidelines and that you may or may not have a choice of which room is utilized for your session.

 

If you decide at any time that you would feel safer or more comfortable by meeting remotely, you will have the option to book a video/phone session through your online booking account at Arbour.

Your Responsibility to Minimize Your Exposure

To obtain services in person, you agree to take certain precautions.  If you do not adhere to these safeguards, it may result in our starting or returning to remote sessions.  You understand and agree to these actions:

  • Before each session, you will review our pre-session checklist and only keep your in-person appointment if you can answer "NO" to each of the questions on the checklist:

    1. In the last 10 days have you had any symptoms of fever; chills; new onset of cough or worsening of chronic cough; shortness of breath or difficulty breathing; sore throat or difficulty swallowing; new muscle aches or headaches

    2. Have you travelled outside of Canada or had any contact with anyone who has travelled outside of Canada in the last 14 days?

    3. Have you had any contact with anyone with a confirmed or suspected case of COVID-19?

  • You will use our alcohol-based hand sanitizer as instructed when you enter the office and will respect all other posted sanitation protocols.

  • You will adhere to our established movement protocols, will keep of distance of 6 feet, and will refrain from physical contact with your therapist or our staff (e.g., no shaking hands).

  • If you are bringing your child, you will make sure that your child follows the same protocols

Arbour may change the above list of precautions if the BC Health Officer deems it necessary. If that happens, we will talk about any necessary changes.

If you arrive for an appointment and your therapist observes that you have any symptoms or learns that you have been exposed to COVID-19, your therapist will ask you to leave the office immediately.  In this case, your therapist will offer the option of meeting remotely or rescheduling the appointment, and any late fees will be waived. 

Arbour's Commitment to Minimize Exposure

Our practice has taken steps to reduce the risk of spreading COVID-19 within the office and we have posted our detailed COVID-19 safety plan on our website and in our office.

We have a established a routine of wipe-down protocols to keep our surfaces disinfected.  Thanks for helping us keep our appointment times to 50 minutes so we have time to finish the wipe-downs between appointment times.

 

If your therapist has any symptoms from the pre-session symptom checklist, your therapist or our office will contact you to offer the option of meeting remotely or rescheduling the appointment. 

If your therapists or any Arbour staff test positive for COVID-19, we will notify you so that you can take appropriate precautions.

 

Your Confidentiality in the Case of Infection

If you have tested positive for COVID-19, Arbour may be required to notify local health authorities that you have been in the office. If we have to report this, we will only provide the minimum information necessary for their data collection and will not go into any details about the reason(s) for your visits.  By signing this form, you are agreeing that Arbour may do so without an additional signed release.