General Data Protection Regulation

You have a right to know what information I keep about you. In addition to the information collected on this form I may also keep notes about our sessions together. These notes are kept manually as encrypted digital documents and are not kept alongside information that identifies you. I may keep written notes which are stored in a lock-box or as encrypted digital documents. These notes are not shared with anyone other than anonymously within supervision or other professional confidential contexts. Under rare circumstances, notes can be subpoenaed in a court of law. Because of this, I try to keep my notes to a minimum. I will keep your notes for the period to which I am obliged which can be anywhere from 3 to 7 years, after which they will be destroyed.

You have the right to request any information I keep about you. As these notes are for my own use only, I would advise that we discuss together your reasons for requesting them in therapy. After this conversation, should you request a written copy, I will require time to compile them and you can have them within one calendar month. I also keep your contact information, email, phone number, address, and GP details in my digital notes so I can contact you if necessary. These contacts may be vulnerable to hacking. So if you prefer, I can refrain from keeping them digitally and instead keep them in a locked file. Please circle the relevant response below: I would prefer you DO/DO NOT keep my contact details in your digital address book.

Emails may also be vulnerable to hacking or miss-sending by human error. If you would prefer not to communicate by email, please let me know. Otherwise, it is best to use email only for logistical purposes (changing session times, etc.). If you would prefer that I not send invoices via email but instead print you a copy on paper each month, please circle the relevant response below: I would prefer my invoices via email: YES / NO

You have the right to have the information I hold about you erased. If you would like me to delete your information, let me know. However, as above, I may need to retain your notes for a required period of time, after which they will be deleted. In general, I will only hold the minimum of information I need about you to carry out my duties, and will regularly audit and clear such data. I am registered with the Information Commissioners Office to hold such records. My reference number with the ICO is ZA789482

I consent and understand the data protection provision: ________________________