Alite Mind Client Informed Consent Form

Alite Mind Client Informed Consent Form

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As part of the provision of service to you, including but not limited to counselling, coaching, mindfulness therapies and classes, ALITE MIND needs to collect and record personal information from you. In accordance with relevant privacy and confidentiality legislation, the information collected may include (but may not be limited to) your name, contact details, medical history, employment status and other relevant information as appropriate.

The collection of this information is a necessary part of your participation in ALITE MIND COUNSELLING / COACHING. Your informed consent must be given prior to commencement of services.

Privacy and Confidentiality

Your personal information is gathered as part of the service you are engaging in. Information is securely stored and is retained in order to document what occurs during coaching sessions. This helps the Practitioner to provide a tailored service specific to your needs.

Limits to Confidentiality

All personal information gathered by ALITE MIND during the provision of services remains confidential except when:

1. It is subpoenaed by a court; or

2. Failure to disclose the information would, in the reasonable belief of ALITE MIND place you or another person at serious risk to life, health or safety; or

3. Your prior approval has been obtained to

a) provide a written report to another professional or agency;
b) discuss the material with another person;
c) disclose the information in another way; or

4. You would reasonably expect your personal information to be disclosed to another professional or agency (e.g. your GP) and disclosure of your personal information to that third party is for a purpose which is directly related to the primary purpose for which your personal information was collected; or

5. Disclosure is otherwise required or authorised by law.

Consequence of Not Providing Personal Information

If you do not wish for your personal information to be collected in a way anticipated by this consent form, ALITE MIND may not be able to provide the COUNSELLING / COACHING service to you.

Consent


If client is under 18 years of age:

This field is for validation purposes and should be left unchanged.

Kind Words

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Rach Jenkins
June 10, 2024

Nat is amazing very supportive and helpful to learn more about meditation The group is a Wonderful safe and comfort zone

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Sean Lappin
May 26, 2024

Natalie’s journey began as a personal one, embodying her practice and then working with her colleagues within her own business to assist them to realise the many benefits Natalie knows are associated with mindfulness approaches. She brings this experience and integrity to establishing Alite Mind. An organisation that she has established to help others on their mindfulness journeys.

Natalie works with people of all ages with a high level of professionalism, grounded in years of study across a range of therapeutic approaches. Along with her genuine, caring and positive personality she consistently delivers high quality services in meditation and counseling.

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Tim James
April 30, 2024

I have known Natalie since January 2020 and am so grateful our paths crossed. Natalie has incredible enthusiasm, is a leader in any area she steps into and has a deep passion and ability to support others. It has been an honour to witness her journey over the last 5 years, from bringing mindfulness practices to staff at her engineering business, to studying meditation, mindfulness and counselling and commencing Alite Mind studio at St Agnes to further support the community. Natalie has created a beautiful space for learning, growth and healing and offers amazing services for young ones and adults. She is a heart centred practitioner always looking for ways to enhance the support available to members of the community. I highly recommend Natalie and her offerings.

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Lisa Forde
April 26, 2024

Natalie is a passionate and authentic meditation teacher who is highly dedicated to her craft and clients. She walks her talk with continued professional and personal development and brings joy, colour and fun into her group sessions and work with children. I highly recommend her classes.

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Ben Walsham
March 27, 2024

I had meditated on and off for a number of years but recently I was seeking something more grounded and consistent. I joined Natalie's group and have seen a massive improvement to my practice. It's a supportive environment and have learnt a lot since joining. Highly recommend for anyone looking to develop their mindfulness!

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