Kelsar Psychology Services

By commencing therapy with Dr Sarah Kelly, it is important that you (the Patient) understand and
agree to some terms and conditions. All new Patients are required to read and confirm the acceptance of these terms and conditions. Confirmation can be provided in writing via email. If written confirmation is not provided for any reason, then by commencing assessment and therapy the Patient agrees to the terms & conditions of this agreement. The Patient is required to respond in writing (via email) if s/he does not agree to the terms and conditions of this agreement. This agreement abides by current GDPR legislation. These terms and conditions are governed by and interpreted in accordance with English law.

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DEFINITIONS
• The ‘Psychologist:” Dr Sarah Kelly
• The ‘Patient:’ You
• The ‘Insurer’ or the Healthcare Provider: for example, AXA PPP HEALTHCARE, AVIVA, ALLIANZ, BUPA, BUPA GLOBAL, CIGNA, CIGNA INTERNATIONAL, WPA, VITALITY HEALTH.
• ‘Assessment’ ‘Therapy’, ‘Therapy session:’ the time spent with the Psychologist
• The ‘Appointment or ‘Session’: is the agreed time slot and arranged time to see the ‘Psychologist’.

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1. SESSION ARRANGEMENTS
1.1 After booking an appointment by either telephone, email or text, the Patient, in accepting the
appointment, agrees to the Psychologist contacting them via email, telephone or text. If the Patient
prefers that the Psychologists uses a specific method of communication (e.g., only text, or only email
or only telephone call), they must state this to the Psychologist.
1.2. Appointments can only be made through discussion between the Psychologist and Patient via
email or telephone correspondence. The patient will receive confirmation of their appointment via
email. The Patient may book several sessions ahead in advance sessions or book one session at a
time. Confirmed appointments will be mutually agreed and subject to the Psychologist’ availability.
1.3. All new patients will be required to complete a proforma that details personal information such
as their full name, birthdate, full current address, next of kin details and GP details. This information
is needed as part of the therapy process and future invoicing. All new insured patients will be
additionally required to provide their insurance membership number and authorisation code for
invoicing purposes. These details will be verified prior to the offering of appointment.

1.4. The Patient agrees to provide the Psychologist with all pre-session written work such as
questionnaires and worksheets (if applicable) as appropriate within the requested timeframe, 24
hours prior to the booked session.
1.5. It is the Patient’s responsibility to attend the pre-agreed session on time. No refund will be given
for any late arrival at the session under any circumstances.
1.6. If the Patient arrives late, an extension of the agreed time or rescheduling the session will not be
offered.
1.7. The Psychologist is not required under any circumstances to go beyond the arranged session
finishing time. The session will be terminated at the end of the arranged time.
1.8. If the Patient is not satisfied with the therapy’s outcome, there is no refund. Dr Sarah Kelly does
not accept any liability in relation to the therapy and modalities used in session.

2. METHODS OF PAYMENT
2.1. The fee for a 50-minutes uninsured/private psychological session either in-person or remotely is
£110, unless otherwise agreed.
2.2. A 50-minutes insured psychological session will be covered by the insurer and invoiced
accordingly. Excess fees will be covered by the Patient and an invoice will be sent to the Patient
unless the patient wishes the insurance to be charged for the excess fees.
2.3. Payment is preferable via a bank transfer 24 hours before the session. Bank details or
alternative payment methods will be discussed with the Patient at the time of booking the
appointment.
2.4. Failure to comply with payment requirements will result in the session being cancelled and the
session will be made available to other Patients.
2.5. It is at the Psychologist’s discretion whether to accept late payment.
2.6. Patients must remain up to date with payments at each session. Failure to do so may result in a
session being cancelled.
2.7. Invoices for insured and/or uninsured therapy sessions may be submitted directly to the
Patient’s insurance. By commencing therapy, the Patient gives consent and agrees for the invoices
and any of his/her personal information that is used for invoicing (e.g., name, home address, email,
DOB, insurance membership number, authorisation code). The Patient is entitled to expect that the
information above will not be used for any other purpose rather than invoicing, will be kept
confidential and stored safely.
2.8. If the Patient would like the Psychologist to write any letters on their behalf, the time in
preparing such letters will be charged a minimum £120. If the Patient requires an extended report,
the Patient must discuss this with the Psychologist. Please note that the Psychologist needs a
minimum of 10 days-notice, if the Patient requires any written documentation.
2.9. Letters to the Patient’s medical insurance for the purpose of requesting further sessions, or a
referral to another medical professional will not incur any additional cost. A draft will be sent to the
Patient to check for any errors or omissions, before agreeing the final version.

2.10. The Patient is required to inform the Psychologist in advance if they are seeking a professional
letter of any kind or are seeking therapy as part of a legal claim.

3. CANCELLATION and REFUND POLICY
3.1. The Psychologist appreciates there are often valid reasons why the Patient may need to cancel
their appointment at short notice. Cancellations made with more than 48 hours’ notice will not incur
any charge. Cancellations made with less than 48 hours’ notice will be fully charged.
3.2 No refund will be issued for any cancelled appointments with less than 48 hours-notice or any
missed appointments. This policy applies under all circumstances including emergency situations.
3.3. If the Patient wants to arrange or rebook an appointment and gives more than 48 hours-notice
in writing, the Psychologist will try to offer an alternative appointment but cannot guarantee to
accommodate the Patient’s request.
3.4 The Psychologist can only offer an estimate of the duration of therapy based on the evidence
base and their clinical experience. This, however, is only an estimate and can be extended or
terminated based on the Patient’s progress.
3.5. The Psychologist reserves the right to terminate a session without a refund if it is considered
that the Patient is a personal risk to him or anyone else they are in contact with. The appropriate
services will also be alerted in all cases. This is a mandatory requirement stipulated to the Health
Care Professionals Council (HCPC). The HCPC governs the practice of Clinical Psychologists
3.6. Personal threats, verbal or physical abuse and vandalism will not be tolerated, and the session
will be immediately terminated. Subsequently, no refund or any monies will be given for the
remaining time of the booked session.
3.7. Even though the agreed session time is 50 minutes, the Psychologist reserves the right to
terminate the session if the Therapy is not considered in the best interest of the Patient. The
Psychologist reserves the right not to disclose the reason for the session’s termination. In these
circumstances, no refund will be given.
3.8 When booking is made from outside the UK, the appointment time and further communication
regarding the appointment will schedule in UK time. If the Patient has booked in the wrong time
zone, the Psychologist cannot be responsible for the error. This will be counted as a missed session
and payable by the Patient.

5. CONFIDENTIALITY, HEALTH, AND SAFETY
5.1. The Psychologist is an accredited member of HCPC and adheres to their ethical guidelines
5.2. Confidentiality is agreed between the Patient and the Psychologist. The Patient is entitled to
expect that the information they give to the Psychologist about themselves, and others will remain
confidential. The Psychologist reserves the right not to disclose to any third party any information
related to therapy sessions. This applies to all circumstances even at the request of the Patient.
Information will be disclosed if it is required by law.

5.3. There are certain circumstances in which the Psychologist is duty bound (by law and in
accordance with Health Care Professional Council code of conduct policies) to breach confidentiality.
Where there is evidence to suggest the safety of the patient, other people known to the patient,
and/or the health, welfare or safety of children or vulnerable adults is at risk of compromise the
Psychologist duty will contact and refer to the appropriate agencies and authorities, including the
patient GP. The Psychologist also reserves the right to break confidentiality and disclose session
information to authorities if the patient discloses any involvement with terrorism and money
laundering.
5.4. If the Psychologist decides a confidentiality breach is necessary, they will endeavour to discuss
this matter with the Patient and any recommendations will be documented. If this discussion is not
possible due to any limitations or unforeseen circumstances (e.g., urgency of the matter), the
Psychologist may have to proceed with the breach of confidentiality without prior notice to the
Patient.
5.5. The Patient should not arrive under the influence of alcohol or non-prescribed drugs. If the
Psychologist has any reason to believe that this may be the case, then the Psychologist will draw the
session to a close or not commence a session.
5.6. The Psychologist recognizes that the process of therapy may, for some, generate strong
emotions. In rare circumstances where the Psychologist has a concern that such emotions have
escalated to the point where they are not, in the Psychologist’s opinion, containable in the room, the
Psychologist will draw the session to a close early.
5.7. The Psychologist does not offer emergency support and cannot offer sessions to the Patient
outside the planned sessions. If the Patient is in danger in any way, it is the responsibility of the
Patient to contact emergency services (A&E), his/her GP or the Samaritans and discuss this with the
Psychologist in their next session.
5.8. The Psychologist is not able to provide immediate support in case of an emergency. If the
Patient is in a life-threatening situation or cannot keep themself safe they are strongly encouraged
to go to a local A&E and if they cannot get there safely to call 999. In addition, if the Patient’s
emotional health deteriorates and they need urgent assistance they are strongly advised to contact
their GP, or, if out of hours, consider whether the Patient needs to go to A&E of your nearest
hospital.
5.9. If the patient feels they can no longer manage psychological distress and requires immediate
support, the NHS website (www.nhs.uk/using-the-nhs/nhs-services/mental-health-services/dealing-
with-a-mental-health-crisis-or-emergency/) is recommended as a guide to seek immediate help.
Other options for gaining support are:
a. Emergency GP appointment
The patient should contact their GP for an emergency appointment when they require support for
your mental health, but there’s no immediate danger to their safety or the safety of others.
b. NHS 111 (24/7)
The patient is should dial 111 for advice and support about what to do in a mental health crisis.
c. Samaritans (24/7)

Call 116 123 (freephone) if the patient needs to talk to someone urgently about how they are
feeling.
d. HOPEline UK
Papyrus runs a listening service if the patient under 35 and may be having thoughts of suicide.
Call 0800 068 4141
Text 07786 209 697
e. CALM helpline (5pm to midnight every day)
If the patient identifies as a male they can ring the Campaign Against Living Miserably (CALM)
helpline to talk or find support. Call 0800 58 58 58
f. Shout text service
Shout is a free text-based support service for people in crisis -the patient is advised to text Shout to
85258 to access support 24hrs a day, 7 days a week
5.10. The Patient’s personal information in any session material is confidential and kept securely.
The Psychologist is expected to be in regular clinical supervision to ensure high quality of
psychological services. Therefore, some information will be shared with the Psychologist’s clinical
supervisor and/or outside clinical sources who are also accredited with a professional body and
abide by the ethical framework and guidelines of the profession. No personal identifiable
information will be used to discuss the Patient with regards to the material that would be shared.
However, discussion topics from the therapy sessions will be used to ensure that the Psychologist is
getting and giving the best assistance possible. The person(s) with whom the Psychologist discuss
Patients’ cases are legally bound to keep information confidential.
5.11. As part of the Psychologist’s aim in offering high quality service, the Psychologist may make
audio and/or video recordings of sessions. This will only be carried out by mutual agreement with
the patient and explicit consent. Recordings are solely used for supervision purposes with the
Psychologist’s clinical supervisor(s) and stored safely in an external drive (password protected).
5.12. Any material produced in the session (e.g., video/audio recordings, session notes, written
homework, and psychoeducational material) is the Psychologist’s intellectual property and
copyright.
5.13. The correspondence and all therapy material shared between the Patient and the Psychologist
is to be used only by the Patient. All written and verbal communication is issued and intended
according to the Patient’s individual treatment plan. If the Patient shares any material that was
intended for his/her exclusive use, the Psychologist accepts no responsibility for the material’s
effecting use on any third parties. Therefore, copying, reproducing or displaying this information
publicly or electronically is not permitted and legal action may be taken against the Patient if that is
found to be the case.
5.14. The Patient under no circumstances is permitted to record (video, audio) the session (on any
device) unless the Psychologist has issued consent in writing.

5.15. The Patient under no circumstances is permitted to make public an unauthorised recording
(video, audio) of the session on any social platform and legal action may be taken against the Patient
if that is found to be the case.

6. HANDLING, COLLECTION, STORAGE AND USAGE OF DATA
6.1. Information is kept securely and confidentially in line with the GDPR and ethical framework and
the codes of practice of the HCPC.
6.2. Session notes or personal details of the Patient are kept in electronic form and paper form. Any
paper notes are kept in a secure, locked filing cabinet. All digital information is stored on a computer
or portable device that is password protected.
6.3. Confidential paper records will be destroyed by confidential shredding when data is no longer
required for lawful processing and storage, e.g., when a legal case has settled, or when 7 years has
elapsed since the completion of psychological work. Electronic data will be permanently deleted by
the same standard.
6.4. The patient should refer to Dr Sarah Kelly’s privacy policy for further details about how full GDPR
compliance is maintained in their practice.

7. PATIENT’S RIGHTS
7.1. The patient has the right to request a copy of the personal information the Psychologist has
collected from them (Subject Access Request), as well as the right to request deletion of data (right
to be forgotten).

8. REVIEWS AND ENDING THERAPY
8.1. The Patient and the Psychologist will review sessions regularly depending on the Patient’s
demand or as the Psychologist finds this appropriate.

8.2. The Patient is not tied into any long-term commitment, and they may end sessions by giving
seven-days’ notice in writing.

8.3. If the Psychologist considers the Patient’s needs are beyond the limits of their competence, the
Psychologist reserves the right to terminate the therapeutic contract. The Psychologist will discuss
this with the Patient in the session and further recommendations, if possible, may be provided.

8.4. If the Psychologist decides to end the therapeutic agreement with the Patient due to unforeseen
circumstances, they reserve the right not to disclose the reason for this decision. However, the
Psychologist will endeavour to give at least 3 weeks-notice.

INFORMED CONSENT
By commencing therapy, I (the Patient) acknowledge that I have read the information above, and I
agree with the terms and conditions of this agreement.