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2. Click the button below to send us your receipt via whatsapp.

3. Our team will reply and proceed with your booking shortly.

OR

Bank in directly to our bank account below:

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8011402910

MIND WAVE PSYCHOLOGICAL CENTRE

TERMS AND CONDITIONS

INFORMED CONSENT FORM

MIND WAVE INFORMED CONSENT FORM

Introduction

We appreciate your interest in our therapy services. We want you to fully understand our services, your rights, and our policies before moving further. This document provides important information about our psychotherapy services offered in-person and online. It ensures that you understand your rights and responsibilities as a client and agree to the terms of therapy.

SECTION 1: Purpose of Therapy Services

Psychotherapy is a professional mental health service aimed to help you address emotional, psychological and behavioural challenges. The therapy provides a safe and confidential space when you can explore your thoughts, feelings and patterns of behavior, gaining insight into your challenges, and develop healthier coping mechanism. Our therapists will work closely with you to achieve greater self-awareness and positive change using evidence-based techniques and personalized guidance.

SECTION 2: Services Offered

All therapy services will be provided online through a secure video conferencing platform.

SECTION 3: Reschedule and Cancellation Policy

To reschedule or cancel a session, you may do so via the Appointlet email received upon appointment booking at least 24 hours before the scheduled time. The entire session price will be charged for cancellations made within 24 hours' notice and the booked session shall be forfeited.

Repeatedly missing appointments may lead to a review of our agreement and your continuation in therapy. If 2 consecutive sessions are missed without prior notice of cancellation, the therapist has the right to terminate the therapeutic partnership. Please be mindful that consistent attendance is crucial for maximizing the benefits of therapy and achieving the best outcomes.

SECTION 4: Risk and Benefits

Psychotherapy can help with emotional distress, improve relationships, and foster personal growth. However, you may experience temporary discomfort from discussing sensitive issues.

For online therapy, potential risks include technical disruptions or reduced non-verbal communication cues.

SECTION 5: Payment

The agreed-upon charge, as shown on the website, will be the cost per session with the selected therapist. Booking of sessions/sessions will be confirmed once the full payment has been made. Please note that if your therapy sessions exceeds the scheduled duration by 15 minutes or more, additional charges will apply.

For psychological assessments, charges will be based on the presenting issues. The estimated fee for psychological assessments with our licensed therapists ranges from RM1200-3500.

SECTION 6: Contract of Service

I understand that the agreement of service is between my selected therapist and me, and that any payments will be made in accordance with Mind Wave’s notification.

SECTION 7: Confidentiality

All information provided during the session will be kept highly confidential and will not be disclosed to third parties without your consent, except as required by law. This includes any written or electronic record pertaining to your therapy as well as material discussed during sessions.

SECTION 8: Exceptions to Confidentiality

There are certain circumstances under which your therapist may be required to breach confidentiality. These include:

• If you pose a serious threat of harm to others or yourself

• If you are a minor under the custody of a legal guardian

• If required by law

For online therapy, sessions are conducted via secure platforms to protect your privacy. You are responsible for ensuring a private, distraction-free environment during online sessions.

SECTION 9: Emergency Protocols

If you experience a crisis, contact local emergency services or go to the nearest hospital emergency ward.

• Malaysia Crisis Hotlines:

1. Befrienders (24 hours) – Call 03-76272929

2. Talian HEAL (8am-12am) – Call 15555

3. Women’s Aid Organization (8am-10pm) – WhatsApp 018-988 8058

SECTION 10: Supervision and Quality Assurance

Your therapist might take part in peer consultation groups or be overseen by a qualified supervisor. For the sake of supervision or quality control, your therapist may provide details regarding your therapy during these sessions. Your identity will be kept private, all supplied information will be as de-identified as possible.

SECTION 11: Supervision Access to Records

Your therapist may maintain confidential written or electronic records pertaining to your therapy. However, Mind Wave or your therapist's supervisor may access these records without your permission for the purposes of supervision and quality control. Mind Wave and your supervisor are both required by law to maintain your information as private and confidential.

SECTION 12: Client Rights

You have the right to ask questions about your treatment or discontinue therapy at any time. You may request for a referral if you wish to work with another therapist.

Contact Us!

Feel free to reach out to us for any questions, requests, etc.