I am interested in receiving virtual services provided by the Pavilion Women’s Centre. My involvement with the Pavilion Women’s Centre is voluntary and confidential.
Location:
I understand that my counselor is in the province of Ontario Canada and is governed by the laws of this province. I am residing and will be present in the province of Ontario during my counselling sessions.
Technology:
I will ensure I have access to appropriate phone service, internet, devices and/or lighting to ensure that the highest level of success and confidentiality.
Pavilion will ensure that technology solutions are compliant with current privacy legislation and Pavilion policies.
If the technology is not working or offline, staff will retry and/or reschedule the session.
Confidentiality
Just as my counsellor is responsible for ensuring the confidentiality of my information within their work environment, I am responsible for protecting my own confidentiality within the space where I am engaging in virtual services.
No other individuals may be present during the session without the consent of the counsellor and the individual.
I will commit to NOT record the session (audio, video, screenshot or any other method).
I understand that confidential services means that the release of any information regarding my involvement with the Pavilion Women’s Centre may only occur with my informed written consent.
Confidentiality in Groups
I will ensure the confidentiality of other group participants, staff and/or presenters shall be maintained and I will never share information that I have learned during group sessions.
Limits of Confidentiality:
I have been informed that the exceptions to the confidentiality policy are:
o When children are at risk of abuse or neglect, Pavilion Women’s Centre staff are legally obligated (as are the general public) to inform appropriate persons in the Ministry of Children, Community and Social Services of any suspected children at risk.
o When an individual indicates that she is a danger to herself or others, the Pavilion Women’s Centre staff is obligated to inform the appropriate authorities (family, doctor, police, hospital, etc.).
o In the case where agency staff are compelled by court order (subpoena).
o Pavilion Women’s Centre staff will make every effort to inform individuals when information must be shared according to the exceptions to confidentiality.
Consent for use of Email Communication:
Email is NOT a secure method of communication. Pavilion cannot guarantee the confidentiality of information that is emailed. Staff will actively assess on an ongoing basis to determine if email is an appropriate communication method, taking into consideration the safety concerns of individuals and their personal circumstances.
o Information emailed to Pavilion becomes part of the client file.
o Email communication between counsellors and clients will be limited to sharing information that could not compromise the safety or confidentiality of the client or the staff person (for example, canceling an appointment or sharing a blank form or resource).
o Pavilion endeavors to respond to email within 2-3 business days but do not respond during hours away from work, when ill or during vacation time. Requests for immediate crisis support should go through the 24 hour crisis line at 1-888-871-9090.
o Counsellors may discontinue use of email with a client at any time if they feel that it is a risk to safety, not helpful to the client or email is being used outside of the uses cited above.
Confidentiality in Groups
I will ensure the confidentiality of other group participants, staff and/or presenters shall be maintained and I will never share information that I have learned during group sessions.