After careful consideration, we have decided to continue with primarily video or phone counselling in June with the added option of in-person sessions upon request (contact your counsellor directly with requests). Starting in July 2020 in-person sessions will be available again and video or phone counselling sessions continue to be available (both in person and video/phone sessions can be booked online starting in July). In accordance with the Worksafe BC guidelines, the following measures will be in place for in person sessions to attend to counsellor and client safety:
Please contact your counsellor with any questions, concerns or feedback regarding how we can best support you. Thank you!
Note: Please refer to Work Safe BC for additional information
https://www.worksafebc.com/en/about-us/covid-19-updates/covid-19-returning-safe-operation/offices
This document contains important information about our decision (yours and mine) to resume in-person services in light of the COVID-19 public health crisis. Please read this carefully and let me know if you have any questions. When you sign this document, it will be an official agreement between us.
Decision to Meet Face-to-Face
We have agreed to meet in person for some or all future sessions. If there is a resurgence of the pandemic or if other health concerns arise, however, I may require that we meet via telehealth. If you have concerns about meeting through telehealth, we will talk about it first and try to address any issues. You understand that, if I believe it is necessary, I may determine that we return to telehealth for everyone’s well-being.
If you decide at any time that you would feel safer staying with, or returning to, telehealth services, that option is still available.
Risks of Opting for In-Person Services
You understand that by coming to the office, you are assuming the risk of exposure to the coronavirus (or other public health risk).
Your Responsibility to Minimize Your Exposure
To obtain services in person, you agree to take certain precautions which will help keep everyone (you, me, and our families, my colleagues, and other clients) safer from exposure, sickness and possible death. If you do not adhere to these safeguards, it may result in our starting / returning to a telehealth arrangement.
· You will only keep your in-person appointment if you are symptom free.
· If you have other symptoms of the coronavirus, you agree to cancel the appointment or proceed using telehealth. If you wish to cancel for this reason, I won’t charge you our normal cancellation fee.
· You will wait outside the office until no earlier than 5 minutes before our appointment time.
· You will wash your hands or use alcohol-based hand sanitizer when you enter the office.
· You will adhere to the safe distancing precautions we have set up.
· You will keep a distance of 6 feet and there will be no physical contact.
· You will try not to touch your face or eyes with your hands. If you do, you will immediately wash or sanitize your hands.
· If you are bringing your child, you will make sure that your child follows all of these sanitation and distancing protocols.
· You will take steps between appointments to minimize your exposure to COVID.
· If you have a job that exposes you to other people who are infected, you will immediately let me know.
· If a resident of your home tests positive for the infection, you will immediately let me know and we will then [begin] resume treatment via telehealth.
I may change the above precautions if additional local, provincial or federal orders or guidelines are published. If that happens, we will talk about any necessary changes.
My Commitment to Minimize Exposure
My practice has taken steps to reduce the risk of spreading the coronavirus within the office and we have posted our efforts on our booking site and in the office. Please let me know if you have questions about these efforts. Building bathrooms are currently cleaned once per day, the counsellors are not able to guarantee they are thoroughly disinfected
If You or I Are Sick
You understand that I am committed to keeping you, me, my colleagues and all of our families safe from the spread of this virus. If you show up for an appointment and I believe that you have a fever or other symptoms, or believe you have been exposed, I will have to require you to leave the office immediately. We can follow up with services by telehealth as appropriate.
If I [or my colleagues] test positive for the coronavirus, I will notify you so that you can take appropriate precautions.
Your Confidentiality in the Case of Infection
If you have tested positive for the coronavirus, you agree to inform the local health authority. If you refuse to do so, I may be required to notify local health authorities that you have been in the office and would inform you prior to proceeding with reporting. If I have to report this, I will only provide the minimum information necessary for their data collection and will not go into any details about the reason(s) for our visits. By signing this form, you are agreeing that I may do so without an additional signed release.
Informed Consent
This agreement supplements the general informed consent/business agreement that we agreed to at the start of our work together.
Your signature below shows that you agree to these terms and conditions.
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Patient/Client Date
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Counsellor Date