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Walk and talk
Consent form & release

Welcome to Turning Tides Life Coaching and Counselling. Please take a moment to review this confidentiality and liability waiver. If you have any questions please be sure to ask your counsellor.

Confidentiality is an integral component of the services provided by Turning Tides Coaching and Counselling. Information about you may only be shared with members of the clinical team for purposes of consultation and to ensure the highest quality of service delivery. Otherwise, information about you or your file is only released with your written permission, except:

  • In cases of a valid court order/subpoena

  • When there is perceived imminent danger to yourself or others

  • If there is current abuse or neglect of a child or vulnerable adult

Clients have the right to access their personal records and request a copy of their files. Client has the right to refuse any particular therapeutic modalities/practices and withdraw consent to counselling/therapy at any time during the therapeutic process.

 

All legal guardians must consent to treatment for children who are unable to consent on their own behalf. If legal guardians are separated or divorced, each party must agree to and consent to treatment.

 

All information received from the client shall be held in strict confidence by Turning Tides Coaching and Counselling. This includes all and any information received verbally, electronically, in writing, or any other form of communication. All such information shall remain in confidence after the coaching and/or counselling relationship has ended.

The client has requested walk/talk therapy as part of their healing process. By signing this form, the client further agree to the following:

  1. I agree that the counsellor is not qualified to diagnose or treat physical or psychological medical conditions.

  2. I agree that it is my responsibility to ensure the my fitness to receive counselling and/or coaching services from Turning Tides Coaching and Counselling and to seek treatment, including diagnosis, from qualified medical professionals if and when required and will not hold Turning Tides Coaching and Counselling legally or financially responsible for any medical conditions and/or accidents that may arise out of walk/talk therapy.

  3. I agrees to seek a doctor’s approval before beginning walk and talk therapy if appropriate.

  4. I agree that if I have any medical conditions that would be detrimental to walk and talk therapy, they agree to disclose this and understand my therapist may not be able to offer this as an option.

  5. I agrees that I am responsible for setting the walking pace of the walk and talk session.

  6. I understand that this is not exercise or workout training, and that while movement may be benefit physically, the focus is not about exercise.

  7. I agree to communicate with the therapist if I am uncomfortable physically or emotionally while participating in walk/talk therapy.

  8. I understand that if my therapist and I encounter a person that I know, I have the right to disclose or not to disclose that I am in a therapy session. I understand that my therapist will follow my lead should we encounter a person I know, and my therapist will make every effort to preserve client confidentiality and privacy while conducting my walk and talk therapy session.

  9. I understand that if my therapist should come into contact with a person he/she knows, my therapist will not acknowledge me as a client or the walk and talk therapy session as counselling to preserve confidentiality.

  10. I agree that I have had all questions answered by my therapist and I understand and agree to the above regarding Walk and Talk Therapy.

  11. I have read and fully understand and agree to the above terms of this Liability Waiver Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law in BC, Canada.

Thank you

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