This form is to inform you about the provision of psychology and related services by Veteran Mindfulness Australia Pty Ltd ACN 641 718 247 and its partnered providers and program facilitators (“us”, “we”, “our”), and for you to consent to receive those services from us and to our management of your personal information.

As part of providing psychology and related services to you, we collect and record personal information from you (eg. your name, contact information, medical history and other relevant information). This collection of information will be a necessary part of your case management, psychological assessment and treatment.

Collection Purposes

To provide you with comprehensive care, we require your consent to collect, use and exchange your personal information for the following purposes:

• Being contacted by an Apex RX GP or a health professional for referral, assessment, or continuity of care purposes;
• The use of secure notetaking tools, which may include digital or AI-assisted software, by practitioners and those involved in your care, to support accurate session documentation and improve care quality. These tools are internal and secure, and data is not shared externally, unless specifically disclosed and explained to you
• Sharing your de-identified and relevant data for clinical peer supervision or consultation purposes. Only information necessary for professional discussion will be used, all identifying details will be removed, and all professionals involved are bound by confidentiality obligations
• To disclose my personal information to trusted third-party service providers (including administrative support, virtual assistants, IT and secure cloud providers), some of whom may be located outside Australia, including in the Philippines, South Africa and the United States, where reasonably necessary to deliver services and operate our business. 
• To exchange your personal information with third parties who are involved in your care; and
• for other purposes which are reasonably necessary in connection with our normal business functions and activities.

You do not have to share anything that you do not want to, but this may affect the psychological services. Your personal information is kept securely and, in the interests of your privacy, used only by authorised service providers and our authorised personnel (as necessary). Your personal information is retained to document what happens during sessions and enables us to provide a relevant and informed psychological service to you. Records are retained in accordance with Australian laws – for at least 7 years form the last date of service, or longer if required by law.

Telehealth Services

Your consent also covers participation in telehealth sessions (video or phone). You will be informed of your practitioner’s location, and you may be asked to confirm your own location at the start of each session for safety and privacy purposes. Please ensure you are in a private and safe environment for the session. If at any point there are concerns for your safety or the safety of others during a telehealth session, emergency services may be contacted to ensure your wellbeing.

Confidentiality

All personal information gathered by us during the provision of our services will remain confidential except where:

1. It is subpoenaed by a court, or if disclosure is otherwise required or authorised by law;
2.  Failure to disclose the information would place you or another person at serious and imminent risk; or
3. You provide consent to share the information. In order for you to receive psychology and related services a referral is required from a General Practitioner.

Referrals and Appointments

In order for you to receive psychology and related services a referral is required from a General Practitioner. If your referral is to be provided by Apex RX, we require your consent to share your health information to facilitate that referral request.

We may also contact you to:

• Obtain additional information about your experience receiving the psychology services; and/or
• To educate and provide you with further information about services that may assist you.

Where your scheduled appointment cannot be attended or rescheduled into the same week, our Duty of Care practitioners will call you within approx. 3 days of your scheduled appointment.

Unless otherwise stated, the psychological services are funded by DVA and may involve discussing traumatic issues and this may trigger psychological changes.

Additional Rights

The Aust. Charter of Healthcare Rights sets out additional rights and is accessible here https://www.safetyandquality.gov.au/our-work/partnering-consumers/australian-charter-healthcare-rights

We have financial or other interests in health services or providers we may refer you to. Please review our Disclosure of Interests here:

Your consent will remain valid for 12 months unless:

• You have decided to withdraw or change this consent;
• There is a significant change in your health, and it is in your substitute decision maker or Veteran Mindfulness Australia’s opinion that a new consent is required.

You may ask questions, request further information, or withdraw your consent at any time without penalty. If you’d like to opt-out or withdraw your consent, please contact our Privacy Officer at info@veteranmindfulness.com.au.