Privacy Policy

In accordance with POPIA (Protection of Personal Information Act No. 4 of 2013):

❖You agree to notify me of any changes to the information provided above.

❖By providing the information above you consent to this information being kept and processed for the purposes of providing treatment and for this information to be used to contact you when necessary.

❖ By providing the information on contact details of emergency contact and person responsible for account, you confirm that you have obtained consent from these persons listed to provide their contact details as the person who will be contacted in the case of emergencies or as the person responsible for the account.

❖ Patient records are kept in accordance with the regulations of the HPCSA.

❖ Note that using your name as payment reference will reflect on practice bank statements and payment notification emails.

PRIVACY NOTIFICATION: PROCESSING OF PERSONAL INFORMATION

I need to collect and process the above and any other relevant personal information about you, including session records/notes and communications/correspondence, that is required to provide psychotherapy services, as per HPCSA regulations and POPIA.

This information will only be used for the purposes for which it was collected (providing psychotherapeutic services); the provision of such services may not be possible should you not provide this information or fail to inform me of changes. Your information will be securely stored in physical and/or electronic forms and I will review security safeguards on an ongoing basis. I may

disclose your information to service providers who are involved in or enable the delivery of services to you, such as medical schemes or other health care professionals, where this is in service of your treatment and where such third parties comply with the privacy requirements as regulated by POPIA. This may include processing and sharing information for the purpose of collecting unpaid debts.