Counselling Consent Form

It is often a big step to enter counselling/Therapy. Congratulations! In order to get the most out of this experience it will be helpful to read and think about the following information. If you have any questions or concerns raise them with me at the beginning. Please read this important information about our services and policies carefully. If you decide to participate the counseling services, please sign it.


Counselling is a confidential process designed to help you address your concerns, come to a greater understanding of yourself, and learn effective personal and interpersonal skills to help you thrive. It involves a supportive, respectful and understanding relationship between you and your counsellor who has the desire and willingness to help you accomplish your individual goals. Counselling involves sharing personal information; this process may sometimes be distressing. In the course of counselling, there may be periods of increased anxiety or confusion. The outcome of counselling is often positive; however, the level of satisfaction for any individual is not predictable.

During your initial session, you and your counsellor will determine an action plan which may include one or more of the following options: self directed study, online assisted therapy, peer or mentoring support, workshops, group therapy, intensive short-term individual therapy, or referrals to other services.

Clients who get the most out of counselling are usually the ones who use their session time to increase awareness, learn new skills and be actively involved in getting what they want from the sessions. They are also the ones who are willing to try out new behaviour in between sessions and take time to reflect on the work. Sometimes it is helpful to write or draw after a session and bring this to your next session. If, at any time, you are left with concerns or discomfort from a session it is very important that you tell your counsellor about this either when it is happening or at the next session.


The counselling sessions will last for 45 minutes and weekly counselling of up to minimum 8 weeks and then review things. Payment for your counselling sessions should be given at the end of each session in case of face-to-face session, and at least 3 hours before in online session, otherwise the session will be cancelled.


If you need to cancel or reschedule an appointment, please give at least 24 hours’ notice; all appointments cancelled or missed with less than 24 hours notice are subject to pay penalty of 500/- INR and no refund will be provided for no show. You are requested to cancel on Friday for appointment of Monday. The counsellor will also do her best to give reasonable notice of any changes.


Continuity of sessions is important. It would be disruptive to suddenly change session frequency; if, however you find that you want to make a change to the arrangements then you need to discuss this with your counsellor. If you do not attend 2 counselling sessions, the counselling space won’t be kept open for you.


All interactions with the counsellor, including the scheduling of your appointments, your attendance at appointments, the content of your sessions, your progress in counselling, and your records, are confidential. However, there are certain exceptions to this, for example if you tell your counsellor about some activity that is illegal or where there is a risk of harm to you or to a third party – under such circumstances the counsellor must obey the law, which overrides the normal rules of confidentiality.


When you feel ready to finish your counselling it is important to bring this up with your counsellor so that together you can plan for ending your work in a satisfactory way. This may take several sessions to accomplish.


Sometimes clients want extra contact with their counsellor. It is inadvisable to mix a social and a therapeutic relationship. Please do not invite your counsellor to join you on any social media. However, you can follow them in social media but don’t feel offended when they don’t do the same. They are not permitted to do so under their strict Codes of Ethics, and refusal can cause offense where none is intended.


Counseling fees are as follows:
50 minutes of individual session: 1500/- INR (for adults)
75 minutes of couple session: 2500/- INR

Student and need-based discount is available, if you need that let’s discuss it before you sign this consent.

Payment can be made via these two modes:
GPay to 9867226459 or
NEFT/IMPS to HDFC Bank, Saving account no.: 11081050013674, IFSC: HDFC0001108

Kindly inform once the session fees is transferred.