You’ll receive a detailed copy of this when you enquire about working with Mel, and you’ll both have a chance to review it first, but also discuss it with Mel in your first session so that the boundaries and expectations are really clear.
Consent Form
Collection and Holding of Personal Information
As part of providing psychological services to you, Dr Mel Irons Psychology will collect and record personal information relevant to your current situation. You’re free to decide what personal information you share. Recording this information helps ensure care that’s informed and tailored to you specifically.
Your information is stored securely within Zanda, our practice management system, which complies with Australian privacy and data protection law. This may include sensitive information such as health history, cultural background, and other details relevant to your treatment.
Client files are retained for seven years after your last contact, after which they’re confidentially destroyed. Any breach of your information is managed in accordance with the Notifiable Data Breaches scheme under the Privacy Act 1988 (Cth).
If your psychologist becomes seriously ill, incapacitated, or passes away, your file will be securely transferred to a nominated senior clinician or practice custodian, who will manage continuity of care and the secure storage or lawful destruction of your records, consistent with professional and legal obligations.
Supervision and Professional Development
As part of maintaining professional standards under the Psychology Board of Australia’s Code of Conduct, your psychologist participates in regular clinical supervision. Cases are discussed for the purposes of clinical guidance and quality improvement. Identifying details, your name, address, or contact information, are never disclosed in this process, and confidentiality is maintained throughout.
Consent Duration and Renewal
Your consent to engage in psychological services remains valid for 12 months from the date of signing, unless withdrawn earlier in writing. After 12 months, your psychologist will seek renewed consent to make sure you remain informed about how your information is collected, used, and shared.
Correspondence with Other Practitioners
To support collaborative care, if relevant, Dr Mel Irons Psychology may correspond with your referring health professional, such as your GP or psychiatrist. A summary letter is typically sent after the initial assessment, at the six-week review, and at discharge. These communications include details relevant to your care, such as diagnosis, treatment plan, and progress. Any additional communication beyond this is discussed with you first.
This information is shared using secure clinical systems, including Zanda. While these systems meet professional security standards, no electronic communication can be guaranteed entirely risk-free.
Your Access to Your Information
You’re entitled to access the information held about you. Requests should be made in writing to Dr Melanie Irons, and access will be arranged within 30 days unless restricted by law. If access is refused under a lawful exemption, such as a risk of harm, your psychologist will explain the reason and discuss your options.
Confidentiality and Its Limits
Everything discussed in session is confidential, with the following exceptions:
If your file is subpoenaed by a court.
If failure to disclose would place you or someone else at serious and imminent risk.
If disclosure is required or authorised by law, including reporting certain criminal activity or notifying child protection authorities. Because these obligations differ slightly by state and territory, your psychologist will let you know if anything specific to your location applies.
With your prior written approval, to provide a report to another professional or agency, or to discuss your care with another person such as a parent or employer.
As noted above, your psychologist also discusses cases in clinical supervision, without disclosing your identity.
Fees
The cost of a 50-minute consultation is $275, payable the day prior to your appointment. If you’ve been referred under a GP Mental Health Treatment Plan, Chronic Disease Management Plan, or Eating Disorder Treatment Plan, you may be eligible for a Medicare rebate. Private health insurance rebates may also apply, depending on your level of cover.
Cancellation and No-Show Policy
To make sure this practice can serve all clients well, the following applies:
Cancellations made at least 48 hours before your appointment incur no fee. Cancellations made less than 48 hours before incur 50% of the session fee. Cancellations made less than 24 hours before incur the full session fee.
Failure to attend without notice incurs the full session fee.
By signing this form, you authorise us to charge the payment method on file for any applicable fees.
Commitment to Treatment
Psychological treatment works best when there’s commitment on both sides. Your psychologist is committed to providing evidence-based care. For that care to be effective, clients are expected to attend at least 80% of scheduled appointments and engage with any tasks agreed to in session.
Frequent cancellations or non-attendance will lead to conversation with your psychologist, but may result in discharge back to your referrer.
Telehealth Services
Sessions may be delivered by phone or videoconference. You’re responsible please for having the necessary technology, a device with camera and microphone, and a reliable internet connection. Dr Mel Irons Psychology covers any platform costs.
Platforms such as Zoom are used and meet Australian security standards, though no online platform can guarantee complete privacy. Email is used for administrative purposes only and shouldn’t be treated as a secure channel for clinical content.
Telehealth can be affected by network instability or other technical limitations. Melanie will discuss with you whether telehealth remains the right fit for your care as we go.
Sessions are never recorded without your prior written consent, and any use of session materials for any purpose requires your consent as well.
Use of AI Tools
To support accuracy and efficiency, Dr Mel Irons Psychology may use AI-assisted transcription tools, such as Heidi or NovoNote, for clinical recordkeeping. These tools comply with Australian privacy standards. No audio recordings are retained, only text summaries of sessions. Some of these tools may process data on servers located overseas as part of how they operate.
You can ask about the specific tool in use and its privacy safeguards at any time. If you’d prefer AI-assisted transcription isn’t used in your sessions, let your psychologist know before treatment begins.
Use of Personal Contact Details
For telehealth sessions, you’ll be asked to provide your contact details and location each time. This is so local emergency or support services can be contacted if ever needed.
Questions and Complaints
You’re encouraged to raise any concern about your care directly with your psychologist in the first instance. If a concern about privacy or information handling can’t be resolved this way, you can escalate a complaint to the Office of the Australian Information Commissioner (OAIC). Concerns about clinical care can be raised with the Australian Health Practitioner Regulation Agency (AHPRA) or your state’s Health Complaints Commissioner.
Acknowledgment and Agreement
You will have the opportunity to discuss any part of this form with your psychologist before agreeing and beginning therapy. You will be asked to confirm that you’ve read and understood the consent form, had the opportunity to ask questions, understand your rights regarding confidentiality, supervision, and information storage, and agree to the terms outlined for psychological services.