Coaching Call Application Form
Congratulations on joining The Mindful Collective. We are thrilled to have you with us! Good on you for pursuing a more compassionate and mindful life.
To help you squeeze as much as you can out of your initial 20-minute consultation I, Amy Kate, would love to gather the following information prior to your sesh. This helps me make sure we are jumping in at the most helpful Stepped-Care level for you.
As part of our online coaching application we include all confidentiality and privacy information as well as other helpful questions. Some of the content may seem a little intense (or strongly worded). That is simply because, as a Psychologist, I must uphold the same ethical standards in my coaching as when I am providing Psychological Therapy. If you have concerns regarding privacy head to here for more information.
Country, State and City:
How did you initially find The Mindful Collective?
Potential focus area for growth during coaching:
What is the potential focus area you had in mind for coaching with me?
Some of the common issues women discuss with me include:
Confidential online coaching gives you many, many benefits, including:
We believe that it is important for you to feel safe when communicating with me online, either through instant messaging, or audio/video calls. This is why we use Sylo | Confidential Communication. Sylo is a simple website/app that was developed in New Zealand and is free for you to use. Sylo does not have a central server storing our communication content (unlike Skype) which means that our conversations are only ever shared between you and me.
With Sylo, we can:
Once I’ve received your completed application via email, I will send you a link to connect via Sylo. Then you can create your account. Before your initial consultation jump onto the app 5 minutes before our start time and check into my waiting room! All you need is:
Online Coaching Service As part of providing an Online Coaching service to you, Amy Kate Isaacs from The Mindful Collective will need to collect and record personal information that is relevant to your current situation. This information will be a necessary part of the psychological assessment and Online Coaching that is conducted. You do not have to give all your personal information, but if you don’t, this may mean the service may not be able to be provided to you.
Purpose of collecting and holding information The information gathered during Online Coaching sessions is seen only by the Psychologist. The information is retained in order to document what happens during Online Coaching sessions and enables the Psychologist to provide a relevant and informed service.
Access to Client Information At any stage you as a client are entitled to access to the information about you kept on file, unless the relevant legislation provides otherwise. The Psychologist may discuss with you appropriate forms of access.
Confidentiality All personal information gathered by the Psychologist during the provision of the Online Coaching service will remain confidential and secure except where:
I consent to the use of electronic communication (SMS, email, fax), as per The Electronics Transaction Act (Qld) 2001, as a method of communication with Amy Kate and The Mindful Collective, within the limits of confidentiality, as outlined above.
Online nature of appointments As the Online Coaching service occurs online there are more possibilities for breaches to online security. Amy Kate has a high level of security on her devices. It is highly recommended that you do as well, in order to prevent online breaches of your information. If you are unsure whether you have a high level of security a helpful resource is: www.staysmartonline.gov.au Your online safety is your responsibility. It is also important that you discuss any communication confusion with Amy Kate directly so that she can resolve the issue quickly.
Cancellation Policy If you need to cancel or postpone your appointments, please give Amy Kate at least 12 hours notice, otherwise you will forfeit that session.
I, , have read and understood the above Online Coaching Consent Form and I believe the level of security on my devices adheres to the Australian Government’s recommendations. I agree to these conditions for the online Online Coaching service provided by Amy Kate Isaacs.
In case of emergency, my preferred contact person’s name is , who is my (e.g., partner, parent, sibling, housemate), and their best contact phone number is
Please Note: If, after reading this page, you are unsure of what is written please discuss it directly with Amy Kate via phone or email prior to your first session. For more information about your privacy please ask to see our privacy information leaflet or consult the Commonwealth Privacy Commissioner www.privacy.gov.au
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If you have questions about the contents of this document, you can email the document owner.
Document Name: Coaching Call Application Form
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