New Clients | Live Well Now Psychology

New Adult Clients

Please complete the new client information form below. Some of the questions may be painful to answer. The more information that you can provide means less time on information gathering during your first session and more time focused on helping you feel better. Feel free to decline to answer any questions that you do not feel comfortable to answer at this point in time. Thank you.

Contact

Contact Details

First name *

Surname *

Date of birth *

Address *

Suburb *

Postcode *

Home phone

Mobile *

Email *

Emergency contact name

Emergency contact phone

GP

GP Details

GP's name

GP's phone number

Medicare Details

Medicare card

Please supply your medicare number, reference number and expiration date as indicated in this example.

Medicare number

Please enter your full, 10 digit, medicare card number as shown above.

Ref no *

This is the small number beside your name.

Medicare expiry date *

Please provide your medicare expiry date in MM/YYYY format.

Household

Other people residing in your home

Name

Relationship to you

Age

Submit

How did you hear about us?

Please specify, if applicable.

Confidentiality and Privacy

As part of providing a psychological service to you, we will need to collect and record personal information. All information and records regarding you will be kept strictly confidential. We will not release any information about you to anyone else, unless you give us written and signed consent to do so. There are some exceptions to this rule including:
1. If you are on a Mental Health Care Plan, Medicare requires that we send a brief report to your Doctor outlining your progress at review and completion of your sessions, usually every 6 sessions. Please let us know If you would like to see that report before it is sent.
2. If you are involved in a court case and we appear on your behalf, or if we are subpoenaed to appear, we are legally required to answer all questions about you.
3. If you indicate that you seriously intend to harm or kill yourself, or someone else, we must notify relevant authorities or potential helpers.
4. If there is an overriding legal or social obligation to do so, we may disclose information to the relevant authorities about serious criminal acts.

Cancellations

Where possible, we appreciate at least 48hrs or more notice to change or cancel an appointment. Because we set aside an entire hour for you that cannot usually be filled at the last minute, cancellations made within 24hrs will incur a $50 cancellation fee. Cancellations within 2hrs or no shows will incur the full fee. Cancellation fees are not claimable from Medicare or your private health fund. As cancellations are a large cost to our business and prevent others from accessing services, repeated failure to provide proper notice may result in you not being offered any further appointments.
EAP Clients
A 50% cancellation fee will be charged to your employer where there is less than 24hrs notice provided and the session will be deducted from your allocated number of sessions.

Provision of a Telehealth Service

Where appropriate the service may be provided by telephone or videoconferencing. You are responsible for the costs associated with setting up the technology needed so you can access telehealth services. Live Well Now Psychology will be responsible for the cost of the call to you and the cost associated with the platform used to conduct telehealth services. To access telehealth consultations you will need access to a quiet, private space; and the appropriate device, i.e. smartphone, laptop, iPad, computer, with a camera, microphone and speakers; and a reliable broadband internet connection.

The privacy of any form of communication via the internet is potentially vulnerable and limited by the security of the technology used. To support the security of your personal information this practice uses Coviu or Zoom which are compliant with the Australian standards for online security and encryption. A telehealth consultation may be subject to limitations such as an unstable network connection which may affect the quality of the psychology session. In addition, there may be some services for which telehealth is not appropriate or effective. Your psychologist will consider and discuss with you the appropriateness of ongoing telehealth sessions.

Your Agreement

Please insert your name and date below to confirm you have read and understood the information outlined above and agree to these conditions for the psychological services provided by Live Well Now Psychology and Health Solutions Pty Ltd.

Name *

Date *

Captcha *

For security verification, please enter any random two digit number. For example: 47

New Couples Clients

Download initial client paperwork for couples

New Child/Adolescent Clients

Download initial client paperwork for children

How can I get the most from my sessions?

Here are some things you can consider, as well as do, to get the maximum benefit from your sessions at Live Well Now.

Try and be clear about what you want to achieve from the sessions. For example, how will your life be different when you are finished with counselling, or how will you know the counselling has been helpful?
Try and attend all appointments on time. The time scheduled is set aside just for you and we will finish at the allocated time.
Come prepared to be open about your concerns. We know it can be hard to open up, but we can’t help you if we do not have a full understanding of what is happening in your life. It is not our place to judge you, only help you get the most out of your life.
Be prepared to try new ways of doing things. We know it can be scary but chances are that what you have been doing may not have been helping so it may help to think and do things a different way!
Do complete any assigned tasks between sessions. You will save yourself a lot of time and money if you work between sessions. Change can be hard and requires practice.
Do keep handouts together in a safe place so that you can refer back to them at a later date.
Do access other resources on this site and follow our Facebook page for additional tips and resources.
Do notice positive change as well as areas of avoidance or struggle. Document these between sessions as it can be difficult to remember by the time your next appointment comes around.

Crisis Situations

Please be aware that Live Well Now Psychology is not a crisis service. Phone calls after hours will not be answered and while all attempts will be made to offer emergency appointments, this may not always be possible. There are a number of crisis services including:

Mental Health Acute Care Team – 1300 64 22 55 (24hr)

Lifeline – 13 11 14 (24 hr)

Beyond Blue – 1300 22 4636

Kids Helpline – 1800 55 1800 (For ages 5 to 25 years, 24 hr)

Parentline – 1300 30 1300 (8am to 10pm)

Communication

To keep costs low we do not have a receptionist. Please leave a message and your call will generally be returned within a few hours. You can also contact by email. Appointments can be managed online.

If you are on a Mental Health Care Plan it is a requirement by Medicare that we keep your GP informed of your progress. This will be done following your 6th sessions or your last, whichever comes first. If you will not be attending any further sessions then please let us know so that we may keep your GP informed.

Please do let us know if you have any questions, concerns or complaints. We strive to provide an excellent service, but if we have failed to meet your expectations in any way we would appreciate your feedback so that we may improve.