Client Consent Form for Psychological Services

Relicus Psychological Services

Relicus is a psychological services organization providing professional mental health support through online and offline counselling sessions. We are committed to ethical practice, confidentiality, and the protection of client rights.

Before starting counselling services with Relicus, we request your consent to the terms outlined below.

By proceeding, you acknowledge that you have read, understood, and agreed to this consent form.

1. Age Requirement

  • Clients must be 18 years or older to provide informed consent for counselling services.
  • If the client is below 18 years, consent must be provided by a parent or legal guardian.
  • By agreeing to this form, you confirm that you meet the age requirement or have obtained appropriate guardian consent.

2. Nature of Services

Relicus provides professional psychological and mental health services, including but not limited to:

  • Individual counselling
  • Psychological support and guidance
  • Online and offline therapy sessions

Counselling is a collaborative process aimed at emotional well-being, personal growth, and psychological support. Outcomes may vary based on individual circumstances.

3. Personal Data Collection & Use

To provide effective services, we may collect the following information:

  • Personal details (Name, Contact Number, Email, Age, Location)
  • Relevant mental health or background information (only as necessary for counselling)
  • Session-related notes (accessible only to the assigned professional)
  • Payment-related information (processed securely through authorized payment platforms)

All information collected is used solely for service delivery and administrative purposes. The information collected will be highly confidential and never shared with third parties without your consent, except as required by law.

4. Confidentiality & Data Protection

Relicus maintains strict confidentiality in accordance with professional ethical guidelines and applicable laws, including:

  • India’s Digital Personal Data Protection (DPDP) Act, 2023
  • Information Technology Act, 2000

Your information will not be shared with any third party without your consent, except in the following situations:

  • Risk of serious harm to yourself or others
  • Legal or statutory obligations requiring disclosure

Clients have the right to access, correct, or request deletion of their personal data, subject to legal and ethical requirements.

5. Client Rights & Responsibilities

  • You have the right to ask questions about the counselling process at any time.
  • You are encouraged to participate honestly and actively in sessions.
  • You understand that counselling is not a substitute for emergency medical or psychiatric care.

6. Consent & Agreement

By submitting this form (electronically during booking), you confirm that:

  • You have read and understood this consent form
  • You voluntarily agree to receive psychological services from Relicus
  • You consent to the collection and processing of your personal data for counselling purposes
  • You meet the age requirement or have valid guardian consent

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