Consent, Privacy, and Clinic Policies
Informed Consent
Psychotherapy services are provided only with your informed and voluntary consent. This means you have the right to understand the nature of therapy, approaches used, potential risks and benefits, fees, confidentiality, and your right to withdraw at any time.
Psychotherapy is distinct from medical care, psychiatry, legal advice, or crisis services, and outcomes cannot be guaranteed.
Consent is ongoing and may be revisited at any time. You are encouraged to ask questions throughout the therapeutic process.
How Consent Is Provided
Formal consent is obtained through a written intake and consent form prior to the start of services. Consent is an ongoing process and may be revisited at any time during therapy.
Directly from you (intake forms, sessions, email, phone, etc.)
From third parties with your consent (e.g., physicians, insurers)
Through secure online booking or practice management systems
Communication and Accessibility
Messages are typically returned within one business day.
Email and text communication are for administrative purposes only and are not secure for clinical matters.
This practice is not an emergency service.
If you require immediate support:
Call or text 988 (Suicide Crisis Line)
Text HOME to 741741 (Crisis Line)
Hope for Wellness (for Indigenous peoples): 1-855-242-3310
Trans Life Line: Call 1-877-330-6366 www.translifeline.org
LGBTQ2S+ Youthline: Call 1-800-268-9688
COAST Hamilton: 905-972-8338
Toronto Distress Centres: 416-408-4357
Ontario Mental Health Helpline: 1-866-531-2600
Call 911 or go to your nearest emergency department
Therapy Process and Risks
Psychotherapy is a collaborative process requiring active participation.
Potential benefits include improved emotional regulation, insight, coping skills, and wellbeing. Potential risks include experiencing emotional discomfort or temporary distress. It is unethical to guarantee regarding outcomes.
Appointments, Sessions, and Cancellations
Standard psychotherapy sessions are 50 minutes. Initial assessments are 50 minutes, consultations are 30 minutes, and EMDR sessions may be 50 or 80 minutes.
All sessions include an additional 10 minutes for clinical report writing by your therapist.
A minimum of 24 hours’ notice is required for cancellations or rescheduling. Late cancellations or missed appointments will be charged 50% of the session fee.
Late arrivals do not extend session time, and the full session fee applies.
Exceptions may be made in cases of emergency or illness at the clinician’s discretion. Repeated missed appointments or late cancellations may result in termination of services.
Fees and Payment
Consultation: $0
Initial assessment: $120
Individual therapy (50 min): $120
EMDR therapy (50 min): $150
EMDR therapy (80 min): $200
Report/letter writing for third parties: $40
Court-related services: $200/hour (including travel)
Payment is due at the time of service unless otherwise arranged. Accepted methods include e-transfer, credit card, and cash.
Sliding scale options may be available based on need and availability.
Fees may be reviewed periodically with advance notice.
Insurance and Billing
Psychotherapy services are not covered by OHIP but may be reimbursed through extended health benefits.
Clients are responsible for verifying coverage, eligibility, and reimbursement limits. Receipts are provided for insurance and tax purposes. Full payment is required regardless of insurance reimbursement. Direct billing is not available at this time.
Privacy and Confidentiality (PHIPA-Compliant)
As a Registered Psychotherapist (Qualifying) in Ontario, I am a Health Information Custodian under the Personal Health Information Protection Act (PHIPA) and am committed to protecting your privacy and confidentiality.
Confidentiality
Your personal health information is confidential and will not be shared without your written consent, except where required or permitted by law. I work under clinical supervision, any discussions about your case with supervision will not include any identifying information.
Limits of Confidentiality
Confidentiality may be limited in the following circumstances:
Risk of serious harm to self or others
Suspected abuse or neglect of a child, elder, or vulnerable person
Court orders or legal requirements
Regulatory investigations
Insurance or legal reporting obligations
Where possible, you will be informed of any disclosure.
Consent to Collect, Use, and Disclose Information
Consent is required for the collection, use, and disclosure of your personal health information.
Implied consent applies within the circle of care
Written consent is required for disclosure outside the circle of care (e.g., insurers, employers, third parties)
Consent may be withdrawn at any time, subject to legal or contractual limitations.
Consent is ongoing and may be revisited at any stage of therapy.
What Information Is Collected
Personal health information may include:
Contact information (name, address, phone, email)
Date of birth
Health history and assessment information
Session notes and clinical records
Billing and payment information
Correspondence related to care
Information is collected directly from you or from third parties with your consent (e.g., physicians, insurers, intake forms, booking systems).
How Your Information Is Used
Your information is used to:
Provide psychotherapy services
Communicate about your care
Maintain clinical records
Schedule appointments
Process billing and payments
Meet legal and regulatory obligations
Your information is not sold or used for marketing.
Storage, Security, and Retention
Records are stored securely using administrative, physical, and technical safeguards, including encrypted systems and password-protected devices.
Access is limited to authorized individuals only.
Records are retained in accordance with professional standards (typically a minimum of 10 years from last contact for adults; longer for minors), after which they are securely destroyed.
Privacy Breach Notification
If personal health information is accessed, used, or disclosed without authorization, you will be notified as required by law. Appropriate steps will be taken to contain and investigate the breach.
Your Rights
You have the right to:
Receive respectful and ethical care
Be informed about qualifications and treatment approaches
Participate in treatment decisions
Refuse or discontinue treatment
Withdraw consent for certain uses or disclosures (subject to legal limits)
Access your records (within legal limits)
Request corrections to your information
File a complaint with a regulatory body
Telehealth and Electronic Communication
Virtual therapy is available and billed at the same rate as in-person sessions.
By participating in telehealth, you acknowledge potential risks including technological disruptions and limits to confidentiality. Secure platforms are used where possible.
Email and text communication are for administrative purposes only and are not secure for clinical matters.
Professional Relationship and Boundaries
The therapeutic relationship is professional in nature.
No social media contact with clients
No dual relationships
Public interactions will not be acknowledged unless initiated by you
Consultation with other professionals may occur to support care, without identifying information.
Termination of Services
Therapy may end when goals are met or when services are no longer appropriate.
Services may also be terminated due to:
Repeated missed appointments
Outstanding fees
Policy violations
Scope of practice limitations
Failure to attend sessions for four consecutive weeks without arrangement may be considered discontinuation. Referrals will be provided where appropriate.
Privacy Concerns and Complaints
If you have concerns about privacy or information handling:
Joey Mercer, RP(Q)
Personalize Recognize Recovery
joey@personalizerecognizerecovery.com
(905) 818-5872
CRPO #19972
If unresolved, contact:
Information and Privacy Commissioner of Ontario
2 Bloor Street East, Suite 1400
Toronto, ON M4W 1A8
1-800-387-0073
www.ipc.on.ca
Website and Service Disclaimer
This website and all communications are for informational purposes only and do not constitute psychotherapy or establish a therapeutic relationship.
A formal therapeutic relationship begins only after intake, informed consent, and mutual agreement to begin services.