NDIS Client Consent Form

Purpose of Services

Therapy sessions are provided as part of your workplace’s Employee Assistance Program. Sessions focus on wellbeing, mental health support, and short term counselling. The EAP funding covers an agreed number of sessions.

Confidentiality

Your sessions are confidential. Your therapist will not disclose the content of your sessions to your employer or EAP provider.

The only information that may be shared is:

  • your attendance, and

  • broad themes or workplace risk issues if required by the EAP agreement.

No personal or clinical details are shared without your written consent.

Limits to Confidentiality

Confidentiality must be broken if:

  • there is a risk of harm to yourself or others

  • there is a legal obligation to disclose certain information

  • there are concerns relating to children’s safety

Session Structure and Fees

  • Sessions funded by the EAP are covered by your employer or the EAP provider.

  • If you choose to continue privately after your EAP sessions conclude, standard private fees apply.

Cancellations

Late cancellations or non attendance may count as a used EAP session, depending on the EAP provider’s policies.

Record Keeping

Clinical notes are kept by the therapist for professional, ethical, and legal requirements. These notes are not shared with your employer.

NDIS Client Intake Form

(Only include what is relevant for therapy work)

Referrer Details

(Leave blank if the participant is self referring)
Organisation and role

Support Coordinator or Key Contact

(If applicable)

Plan Manager

(If the plan is plan managed)

Emergency Contact

Participant Goals

(NDIS requirement: goals must connect to supports)

Requested Support