Contract with Dr. Lieuwkje van der Merwe
Terms and conditions
Therapy is a relationship that works in part because of clearly defined rights and responsibilities held by each party. This frame helps to create the safety to take risks and the support to become empowered to change. As a client in therapy, you have certain rights that are important for you to know about because this is your therapy, whose goal is your well-being. There are also certain limitations to those rights that you should be aware of. As a therapist, I have corresponding responsibilities to you.
My Responsibilities to You as Your Therapist
- With the exception of certain specific exceptions described below, you have the absolute right to the confidentiality of your therapy. I cannot and will not tell anyone else what you have told me, or even that you are in therapy with me without your prior written permission. I may legally speak to another health care provider or a member of your family about you without your prior consent, but I will not do so unless the situation is an emergency. I will always act so as to protect your privacy. You may direct me to share information with whomever you choose, and you can change your mind and revoke that permission at any time. You may request anyone you wish to attend a therapy session with you.
- If you select to communicate with me by email at some point in our work together, please be aware that email is not completely confidential. All emails are retained in the logs of your or my internet service provider. While under normal circumstances no one looks at these logs, they are, in theory, available to be read by the system administrator(s) of the internet service provider.
- Please note: My administrative team and Medical Practice Billing Solutions (3rd party responsibile form my practice's accounts) will have access to some of your personal information for administrative purposes only. My administrative team and Medical Practice Billing Solutions have both sighed a confidentiality agreement binding them to only use this information for the purpose it was meant for.
The following are legal exceptions to your right to confidentiality. I would inform you of any time when I think I will have to put these into effect.
- If I have good reason to believe that you will harm another person, I must attempt to inform that person and warn them of your intentions. I must also contact the police and ask them to protect your intended victim.
- If I have good reason to believe that you are abusing or neglecting a child or vulnerable adult, or if you give me information about someone else who is doing this, I must inform Child Protective Services within 48 hours and Adult Protective Services immediately.
- If I believe that you are in imminent danger of harming yourself, I may legally break confidentiality and call the police or the police crisis team. I am not obligated to do this, and would explore all other options with you before I took this step. If at that point you were unwilling to take steps to guarantee your safety, I would call the crisis team.
- I keep very brief records, noting only that you have been here, what interventions happened in session, and the topics we discussed. You have the right to request that I correct any errors in your file in terms of personal information. I am not by law, allowed to give you the notes made in your file. You however have the right to request that I make a copy of your file available to any other health care provider who is able to interpret the notes in the correct way, at your written request. I maintain your records in a secure location that cannot be accessed by anyone else.
- You have the right to ask questions about anything that happens in therapy. I'm always willing to discuss how and why I've decided to do what I'm doing, and to look at alternatives that might work better.
Appointments and accounts
- Please note: If an appointment is not confirmed before 12:00 the day before the scheduled appointment, the appointment will be cancelled.
- If an appointment is not cancelled and the patient did not show up or make arrangements, the patient will receive a cash account for which they will be personally responsible.
- Accounts older than 90 days overdue will be handed over for collection.
- If you are a private patient, payments can be made via card or cash before the consultation takes place.
- Medical aid is accepted. When funds are depleated, you will personally be liable for any amount the medical aid did not cover.
- If you are on a medical aid, you will be charged the medical aid tariff. If you are a private patient, you will be charged at the rate agreed upon by the practice.
- You are responsible for coming to your session on time and at the time we have scheduled. If you are late, we will end on time and not run over into the next person's session.
- If a patient misses three consecutive sessions, any time slots allocated to them thereafter will be reallocated to other patients.
Please note: The person who is allocated as the main member or as the person resposible for the account will be personally liable for the accounts if the account was not paid by the patient or medical aid.
- For emergencies between 07:30 – 16:00 please call the office. After hours please call Vista Clinic: 012 664 0222 or Denmar Psychiatric Hospital: 012 998 6062/3/4/5.
- Messages will be retrieved at regular intervals.
- Always leave all your contact details when leaving a message.
- Should the assessment be that you are a danger to yourself, hospitalization may be considered.
- The Psychologist bears no responsibility should you follow a course of action that may harm you.
- By signing this contract you give full consent for this practice to communicate appropriately with other professionals or with yourself via electronic media, i.e.: E-mail, sms, voicemail.
For remote sessions [skype, telephonic, instant messaging, e-mail]:
- Clients should complete and send back all the required paperwork prior to the session to prepare the therapist and the client for the session.
- All payments are to be made prior to the session at the rate agreed with by the practice.
- Clients are responsible for making the call for the session. If unable to, the cost will be added to the invoice as per service provider rates.
- This practice will ensure confidentiality as far as possible, however the client takes note that electronic media is NOT a confidential medium.
- This practice does not invite or respond to invitations to participate in profile based networks [Twitter, Facebook, MySpace, MXiT, WhatsApp] for confidentiality reasons.
- Where possible the Psychologist would like an established relationship with an individual before electronic sessions take place.
- This practice will attempt as far as possible to check mails at least every second day.
- When the therapist is on leave – alternate arrangements will be made.
- Where possible please ensure an undisturbed space where you will be able to reflect and concentrate while taking part in an electronic session.
- Please be aware that connectivity issues are rife – please have an alternative option available while in session should the connection break.
- This practice does not respond to ‘please call me’ sms’s.
Dr. Lieuwkje van der Merwe: POPI act
This is the POPI policy of Dr Lieuwkje van der Merwe that explains how we deal with your personal information under the Protection of Personal Information Act (“POPI”).
We are committed to protecting your privacy and to ensure that your personal information is collected, used and disclosed in a manner that fully complies with POPI.
The nature of any personal information we collect from you will depend on the context in which you provide it and the purpose for which we collect and use it. We will only collect the personal information that we need for that purpose.
As broadly stated above, we will only use your personal information for the purposes for which it was collected.
We may use your personal information to comply with legal or regulatory requirements under which we operate or which otherwise apply to us.
We may disclose your personal information when we have a duty or right to do so under the law, or to protect our rights, staff, clients, or third parties.
We will continue to review our security protocols and processes to ensure that your personal information remains secure. Our security protocols and processes entail physical security, computer and network security, access control, retention and disposal of any applicable personal information, monitoring access and use of personal information, detecting and responding to security threats, investigating and responding to security breaches, and internal policies on acceptable use and privacy.
Click here for information about the PAIA act/ section 51 manual