Service Consent And Liability

Waiver and Liability Agreement

1.Purpose of This Agreement

This Waiver and Liability Agreement outlines the limits of responsibility for Registered Social Worker / Psychotherapist under Oak Therapist, in providing counselling, psychotherapy, assessments, court-related programs, or documentation. By signing below, I acknowledge that I understand and accept these conditions.

2.No Guarantee of Outcome

I understand and agree that:
  • The therapist cannot guarantee specific outcomes from therapy.
  • Participation in anger management, relapse prevention, parenting support, or other programs does not guarantee positive legal or court decision.
  • Letters, assessments, or reports do not guarantee decisions from insurance companies, immigration authorities, employers, courts, or lawyers.


3.Personal Responsibility

I acknowledge that:
  • I am responsible for my actions and decisions during and after therapy.
  • Difficult emotions may arise during the therapeutic process.
  • I must inform the therapist immediately if experiencing increased distress, risk, or safety concerns.


4.Limits of Liability

To the fullest extent permitted by law, I agree that:
  • The therapist is not liable for emotional distress, legal outcomes, immigration results, insurance decisions, employment consequences, or third-party interpretations of documentation.
  • The therapist’s liability is limited to the cost of the service(s) paid.
  • The therapist is not responsible for decisions or interpretations made by legal, governmental, medical, or insurance entities.


5.Third-Party Communication

I understand that:
  • If I request communication with a lawyer, insurer, employer, legal authority, court, or immigration body, I assume full responsibility for how released information is used.
  • Once information is disclosed to a third party, the therapist cannot control further use, interpretation, or distribution.


6.Court-Involved Services

If I am involved in legal or court matters, I acknowledge:
  • The therapist is not obligated to attend court unless agreed upon in writing and billed separately.
  • Program completion is not a guarantee of legal compliance unless accepted by the court.
  • The therapist is not responsible for filing deadlines or legal requirements.


7.Risks of Technology and Telehealth

I understand that:
  • Email, text messaging, video platforms, and phone calls carry inherent privacy risks.
  • The therapist is not responsible for breaches caused by third-party platforms, internet providers, or device vulnerabilities.
  • I am responsible for maintaining privacy in my environment.


8.Safety and Emergency Limitations

I understand that:
  • The therapist does not provide crisis or emergency services.
  • In emergencies, I must contact 911, a crisis line, or visit an emergency department.
  • The therapist is not liable for harm caused by failure to seek emergency support.


9.Financial Responsibility and Refund Policy

I acknowledge that:
  • All fees must be paid before or at the time of service.
  • Fees for reports, letters, forms, and assessments are non-refundable.
  • Missed or late-cancelled appointments may incur 25$ fees.
  • No refunds are issued for program non-completion or legal outcomes.


10.Indemnification

I agree to indemnify and hold harmless the therapist from any claims, losses, damages, or liabilities arising from:
  • My actions or decisions in or outside therapy.
  • Court, insurance, immigration, or workplace consequences.
  • Misuse or misinterpretation of letters, reports, or assessments.


11.Acknowledgment

By signing below, I acknowledge that:(Required)
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Consent Form

Informed Consent to Treatment

I understand that I am engaging in psychotherapy/counselling services with Registered Social Worker / Psychotherapist under Oak Therapy. I acknowledge that:
  • The nature, purpose, and expected benefits of therapy have been explained to me.
  • I understand that therapy may involve discussing difficult emotions, trauma, or sensitive personal experiences.
  • I may ask questions at any time and may withdraw consent at any time.


Confidentiality and Its Limits

I understand that my information is confidential except in situations where disclosure is legally required, including:
  • If there is risk of serious harm to myself or another person.
  • Suspected abuse or neglect of a child or vulnerable adult.
  • Court orders, subpoenas, or legal mandates.
  • Professional or regulatory reporting obligations.
I acknowledge that my therapist will make reasonable efforts to protect my privacy under applicable laws (PHIPA/PIPA).

Communication and Technology

I consent to optional communication methods including email, text messaging, phone call or telehealth platforms. I understand:
  • These methods have privacy risks.
  • I am responsible for ensuring my own privacy when receiving communication.

Telehealth Consent

If engaging in video or phone sessions, I understand:
  • Technology may fail or experience interruptions.
  • I am responsible for securing a quiet and private location.
  • Telehealth is not appropriate for emergency situations.


Fees, Billing, and Policies

I acknowledge:
  • Fees are due at the time of service unless otherwise arranged.
  • Cancellations require 24–48 hours’ notice (per clinic policy).
  • Missed appointments or late cancellations may result in 25$ fees.

Client Rights

I understand that I have the right to:
  • Ask questions and receive clear information.
  • Withdraw from therapy at any time.
  • Request access to or correction of my file.
  • Be treated with respect, dignity, and professionalism.

Acknowledgment of Understanding

I confirm that:

Release of Information (Optional)

I authorize the therapist to communicate with the following individuals (lawyers, doctors, insurers, etc.) with my written  or verbal consent: