Terms of Service

TERMS OF SERVICE

I acknowledge that I have understood and agreed to the following:

that I have received a copy of the terms and conditions (provided separately) and have had an opportunity to ask questions on aspects thereof that I was uncertain about.
I acknowledge that if I am uncertain regarding any aspect of the processes, consents, policies and/or forms, I will clarify this with the practice.
I acknowledge that the appointment will be confirmed by a text notification 24 hours prior thereof.
that in the event that the patient cannot attend the appointment, notice should be given 24 hours prior to the appointment. In the event that someone cannot attend the appointment without the said notice, the practice reserves the right to charge the full consultation fee, regardless of the reason for the cancellation.
I understand that when I am late for an appointment (20 minutes or more), the session will be cancelled; however, the person will be held responsible for the fees of that session.
If I am unable to reach the practice telephonically to cancel my appointment I acknowledge that I am encouraged to send written communication about my wish to cancel the appointment via text or WhatsApp. Communication received via such medium within the cancellation period, whether read and confirmed or not by the practice will suffice as cancellation.

Informed consent for Treatment

Confidentiality

I understand that all information regarding me will be treated as medically confidential.
I understand that confidentiality is legally required to be breached in instances where the person in therapy prove to be in danger of harming him- or herself, another human being or animal, in cases of apparent, suspected or potential child abuse or neglect, or in cases where a court issues a summons for records or testimony.
Hope@Work Practice may use forms of communication, such as messages or emails, which despite all efforts to maintain confidentiality, may not be guaranteed due to the nature of technology.
In the event that family members or other individuals make contact with the practitioner requesting information or meeting concerning the person in therapy, all prescribed limits of confidentiality will be adhered to in accordance with the South African Council for Social Service Professions (SACSSP) and in accordance with the POPI Act. This means that the therapist will not disclose any details whatsoever regarding me, my sessions or my child's, as well as any therapeutic content. I am in my rights to request and consent to a family session, where applicable, which will only take place if I am present in that session.
The practice will only communicate with me directly and not with an individual on my behalf unless I provide the practice with my written consent to communicate with a specific indicated person. Such consent would be required to specifically indicate the individual who can be communicated with, duration that such communication is required and specifications about the content that may be discussed with such an individual.

Client Records

I acknowledge that client records are kept for a period of 6 years from the date of last consultation or as regulated by professional standards set out by the SACSSP and in accordance tot he POPI Act.
I acknowledge that I am a client of Hope@Work Practice and therefore my client records remain property of this practice for the duration as set out as above.
I acknowledge that if I want to study a copy of these records, I will need to do this in the presence of the practitioner due to the professional nature of these notes. An additional fee will be charged.

Supervision & Multi-professional teams

I understand that any therapeutic or social information regarding me may, with my permission, be discussed with a relevant multi-professional team.
My information may be discussed with relevant parties for the purpose of supervision, within a confidential setting, to enable my practitioner to provide me with improved therapeutic strategies.
I am aware that my practitioner, although fully qualified and registered, may be continuously taking on additional training to increase competency and therefore may also be receiving training within the practice.

Therapeutic Treatment

I acknowledge that therapeutic treatment will only be provided in the capacity as agreed upon between the relevant parties. I am aware that my practitioner may not overlap between working in a legal capacity and a therapeutic capacity. This would mean that my practitioner,in a therapeutic capacity cannot provide me with a report for legal purposes, whatsoever.
I am aware of the difference between a forensic investigation and a clinical assessment and acknowledge that my practitioner only conducts clinical assessments as part of therapeutic intervention.
During my continuous sessions myself and my practitioner will agree upon a treatment plan, which may be adapted and changed during the therapeutic process. I hereby consent to ensure that I understand the treatment plan, risks and benefits of the therapeutic process. Thereby agreeing to release Yolanda Huijsamer of Hope@Work Practice to the extent permitted by law, from all claims for any loss or damages as a result of the treatment.
I hereby state that I have taken note of my practitioner's qualifications and training and I consider her a suitable qualified person to treat me or my child.
I understand that the sessions will be scheduled once a week, but should the need arises for more sessions per week, this will be communicated and agreed upon in writing via email and that it will form part of this agreement.
I understand that it may happen, in some cases, that the date and time give for a next appointment may be changed due to unforeseen circumstances, although the therapist will try to avoid this at all times.

Reports

In order for any reports, letters, medical aid or other applications to be disclosed, a consent for disclosure application needs to be completed as per the POPI Act and PAIA regulations as any such report, letter or application will contain my personal information.
A report will not be provided for legal purposes of whatsoever nature if the purpose of treatment is not of a legal nature and has not agreed upon on commencement of therapeutic treatment.
I understand that this practice does not engage in the provision of reports utilized for forensic purposes. If such a request is made, I will be directed to a professional that can assist me with my requirements.
I understand that this practice does not provide anyone with reports, except where requested to do so by an attorney, welfare organization or the court. An additional fee will be charged.

Billing Administration & Medical Aid Claims

I'm aware that in the event of claiming through medical aid, the practitioner will need to include an ICD-10 code on my invoice, which will give the medical aid an indication of the condition that I am being treated for. I have the full right to know what this code will be and discuss this further with my practitioner. If I refuse for this information to be submitted as a claim to my medical aid, I will be liable for the payment of my sessions based on the card rate of the practice.
I am aware that in the event of submitting a claim through medical aid, the medical aid may request additional information as per their terms and conditions.
I authorise the practice to process my personal information in order to perform their services. Including the relevant release of any of my clinical information such as diagnostic code and other information required to process my invoices in order to submit claims or to collect outstanding balances on overdue accounts.
By submitting my claim to my medical aid I understand that this may mean that other members/beneficiaries on my medical aid scheme may have access to information pertaining to my session or claim once this is submitted regardless of measures taken by the practice to protect my personal information.

Children

Children over the age of 14 years are required to give therapeutic consent and are entitled to the same confidentiality as that as an adult. This would mean that the practitioner may not disclose any therapeutic information to another party if the child has not given their consent for the practitioner to do so. As the parent or legal guardian of the child patient I acknowledge this confidentiality agreement. Parental consent for therapy is not legally required.
For children under the age of 14 years to attend therapy, consent from both parents in the case of divorce is required, except in cases where one parent can prove that he/she has full legal custody of the child. I would require that both parents sign forms which will provide consent for the child to attend therapy. Therapy cannot commence until I have received consent from both parents.
The practitioner will discuss the plan and structure regarding feedback on my child's therapeutic process. The practitioner may not be available for feedback outside of the agreed upon structure, and I understand the limitations of my therapist's time as she may be attending to other clients and work hours are appreciated. For any communication regarding treatment, emails or Whatsapp texts are preferred.
Although my child might be over the age of 14 and is required to give therapeutic consent, in accordance with the POPI act a legal parent or guardian would be required to give consent for non-therapeutic gathering and disclosure of information.
As a parent, I give permission for my therapist to liaise with my child's school and his / her teachers, in order to provide collateral information and insight into their functioning.
I understand that Yolanda Huijsamer will always take an objective and neutral stance towards parents, even though the outcome of therapy or assessment might not be in favour of the person liable for payment.

Sessions via Technology

In the event that I choose to attend therapy using a form of technology such as Zoom, Skype, Facetime, WhatsApp calls, video calls, or via a phone call, I understand that my practitioner will schedule an appointment time with me and will provide such a service in a confidential setting and provide the service to the best of her capabilities. I acknowledge that potential technical difficulties may be experienced, and Hope@Work Practice will not be held liable for diminished levels of service due to such technical factors.
In the event that I require therapy using a form of technology as stated above I would be responsible for ensuring that I am in a confidential setting within which the session would be conducted.
My practitioner reserves the right to terminate sessions in the event that my environment is not confidential. In accordance with the POPI Act and SACSSP regulations this will be done to protect my personal information and confidentiality.
I will be responsible for ensuring the application and any required software is downloaded and that I have access to the telehealth platform. Please be aware that clients are responsible for any costs incurred in relation to the provision of their own software, hardware and data usage associated with telehealth services.
Telehealth services requires clients to have a secure WIFI or internet connection and a working webcam and audio on their device.
Clients should be aware that misunderstandings may occur due to connection problems causing image delays or less than optimal image quality. Teleconferencing generally limits the amount of non-verbal information exchanged between the practitioner and clients and as a result, misunderstandings may occur. Clients are asked to please have patience with the process and clarify information if they think their practitioner has not understood them well and to also be patient if their practitioner asks for periodic clarification.
The privacy of any form of communication via the internet is potentially vulnerable and limited by the security of the technology. Clients are responsible for understanding the potential risks of confidentiality being breached through unencrypted email, in transit by hackers or internet service providers, lack of password protection or leaving information on a public access computer. My practitioner will make every effort to keep all information confidential. Likewise, clients are asked to take responsibility for creating and using additional safeguards when the computer used to access telehealth services may be accessed by others, such as creating passwords to use the computer, keeping email and passwords secret, ensuring they fully exit all online therapy sessions and email, and maintaining security of their wireless internet access points. This applies to all online courses purchased through the Hope@Work Practice website.
I acknowledge that any online courses purchased through the Hope@Work Practice website are not a substitute for therapeutic services offered by psychologists, psychiatrists or any other mental health care practitioner.

Communication with the Practice or Therapist

Any communication with my practitioner between sessions needs to be made via email or WhatsApp texts for the purpose of record keeping. My practitioner may not be available to consult with me telephonically between sessions.
Records of electronic communication will be kept only for the reasonable duration in relation to the purpose of the communication.
I acknowledge that my practitioner may not be able to respond to my email or text message timeously due to the consultation nature of the practice.
I acknowledge that the possibility exists that my practitioner may only respond to my email or text messages within office hours, which is Monday to Thursday, 08:00-18:00.

Payment & General Terms of the Practice

By using the services of the therapist, you confirm that you accept the following payment terms:

Medical Aid Claims

If I'm not the principle/main member of my medical aid, I agree that the principle/main member is aware of the consultation and that they have given permission for the psychological sessions to be claimed from the medical aid.
It remains my responsibility, and not that of the practice, to familiarise myself with the benefits and terms and conditions associated with my chosen medical cover.
Should there be a shortfall in medical aid funds, or the funds become depleted, the person whose signature appears on this document will be held responsible for any outstanding amounts unless a signed letter is received from the individual listed under person responsible for account. You will be notified by the practice regarding any outstanding amounts.
I acknowledge that I am responsible, and not Hope@Work Practice, to resolve any queries I may have regarding my account with the practice with my medical aid.
Hope@Work Practice cannot be held responsible for any errors or incorrect use of funds made by your medical aid.
In the event that there is a query regarding payment of my medical aid, I give the practice permission to contact my medical aid to resolve such an issue on my behalf, and in doing so consent to the practice sharing my personal information with the contact person at my medical aid.
If I feel that my medical aid scheme should have paid my account in full, I can lay a complaint at the Council for Medical Schemes by emailing them at complaints@medicalschemes.com.

Payment Terms

I am responsible for any outstanding amounts on the account, including amounts not paid by a medical aid claim any co-payments that may apply.
Rates are standardised as of February each year, regardless of medical aid rates. Rates can be made available upon request.
Hope@Work Practice follows a 30 day terms policy and I agree to settle the practitioner's account within full before the 7th day of the following month, irrespective of contracts, agreements or arrangements that I might have with any medical scheme or third party.
Any payments made via EFT needs to contain the account number or full name as reference in order to allocate my payment to my account. I acknowledge that this reference may reflect on the practice bank statements, banking profile, and payment notifications received. In the event that I provide my name or that of my child as reference, I am consenting to this personal information being disclosed in instances where such banking documentation may be shared or required by third parties.
No Cheques, Diners club Cards or American Express Cards are accepted as methods of payment.
Refunds will not be made for incorrectly paid or pre-paid amounts, whether due to medical aid or private error, and will remain as credit on your account.
Clients are encouraged to approach the practice immediately if they experience problems with the payment of the account.
Accounts are handed over for legal debt recovery after 90 days. Any costs associated with such actions will be incurred towards the person responsible for the account. This may result in having a bad credit record.
As the responsible for this account I agree that the practitioner may seek information from any credit bureau when assessing the responsible person and/or patient's application for credit, or at anytime during his/her continuing indebtedness to the practitioner including tracing or confirming his/her whereabouts.
I agree that the practitioner may disclose the existence of the account to any credit bureau, sharing both positive and negative payment information about such account.
As the person responsible for this account, I will be the recipient of statements and other communication from the practice. If another individual is elected to receive statements and communication, we require this to be requested in writing with both the client and elected statement recipient to give consent for this request.
If the client is a minor (under 18 years of age) the parent that has signed this form will be the statement and communication recipient unless written consent is received from the elected statement recipient.

Sessons via Technology

In the event that I request a session using a form of technology, I will be responsible for the payment and such a payment needs to be made at a time of my scheduled session, and proof of payment emailed to Hope@Work Practice with my name or account number as reference.
In the event that I have outstanding fees form previous sessions, the practice reserves the right to postpone any future dated sessions up until such a time after which my payment has been received.

Forex Payments

Any payments made to Hope@Work Practice in foreign currency will be charged inclusively of the additional forex bank charge. I will therefore be responsible for the session rate, as well as any additional costs associated with the forex payment.

Third Party Payments

Hope@Work Practice will not accept payment from a third party (such as a company or an individual paying on behalf of another) without written, signed letter from the third party stating the number of sessions that they have agreed to, what their expectations of the sessions would be (such as report) and a commitment to adhere to the payment terms. Including and not restricted to the costs incurred and time required to acquire requested documentation.
Hope@Work will not be involved in any payment agreements between parties for whatsoeve reason.
Hope@Work Practice as the right to charge for any additional documentation and the time spent acquiring such requests by a third party due to documentation requirements, in order to receive payment.

Reports, Letters and Assessments

Any reports, motivational letters or forms requested will incur a fee which will be charged for according to the duration spent on compiling the report. These charges will be payable according to the fee rates and not claimed through my medical aid.
I will be required to provide written consent for any reports, letters or forms requested to be sent by the practice by completing the required consent form in accordance with the POPI and PAIA Act.
Any home or school observations will be charged for as per time utilized.

Termination of Therapeutic Services

If my account has any outstanding amounts the practice may elect to pause or stop providing therapeutic services due to non-payment, and therapeutic services may be resumed once full outstanding payment is received.
My practitioner may elect to terminate therapeutic services in the event that my account is not paid.

Complaints and Compliments Policy

I am requested to address any concerns or complaints at the time that such concerns or complaints arise directly with my practitioner.
I am aware of the fact that I have the right to report any professional misconduct to the Board of Social Services Profession at www.sacssp.co.za. I confirm that I am aware that Yolanda Huijsamer has the right to claim against me if found not guilty. Hope@Work Practice holds Professional Liability Insurance under AIG Policy Number 720004226.

Protection of Personal Information Act (POPI)

The practice will collect, treat and store my personal information for the purpose of providing therapeutic services and for billing reasons. All information is processed in a reasonable and relevant manner, as well as treated with confidentiality and in line with the POPI Act.
In order to keep my information up to date, i will supply the practice with my latest contact detail and ask for deletion of any information I no longer want held by the practice.
Clients have the right to any documentation held by the practice containing their personal information. If a client wishes to request specific information held by the practice I am required to submit an application form as per the PAIA policy. The practice reserves the right to approve or deny applications.
All attempts have been made to ensure that our procedures around systems used and mediums of providing our therapeutic services are POPI compliant.
Our Privacy Policy and all relevant POPI Act documentation is available on request which outlines the various legalisation and processes and policies that we follow.
In the event that there is a breach of my Personal Information in accordance with both SACSSP and the POPI Act, I will be contacted and informed of such in accordance with the guidelines set out by the above-mentioned regulatory bodies.

Please note that the terms and conditions of service are updated on a regular basis and by continuing with therapy I consent to the terms and conditions of the Practice.