Consent Form

Welcome! Now that you are here, this means you are already on the journey to improve your mental and emotional health. It is important for you to understand the scope of counselling and therapy, and what your rights are, as a client.

Our Therapist/Doctors, healers and Therapist/Doctors are trained in various modelaities from main stream & complimentary & alternative medicine. They might be using a specific approach based on what they deem best in your case. They will also discuss with you the intervention they have chosen for you.

You will be charged a certain fee for the services rendered. You are free to discontinue the service at any time.

Please read the content on this page carefully and fill in the details. It is for your benefit. It will take approximately, 5 mins to fill up this form. This form does not require a signature and the completed and submitted form will be considered as your agreement/consent to availing the session.



Client Rights:-


You are the recipient of psychological and/or health related services rendered by Manushee. You are the client and given below are your rights.



  • Respect & Dignity: To be treated with respect, dignity, and without discrimination.

  • Informed Participation: To receive clear information about the therapy process and ask questions on what to expect during and outcome of the therapy.

  • Consent- To provide informed consent

  • Discontinuing- The client may cease to continue therapy anytime, without any impediment and may return to therapy anytime.

  • Access to Records: To access your therapy records upon request, as per professional guidelines.

  • The client has the right to review his or her records from the practitioner.

  • Right to confidentiality: Within limits provided for by law, all records and information acquired by the Therapist/Doctors shall be kept strictly confidential in accordance to the principles of a doctor-patient relationship. All information will not be shared or revealed to any person, agency, or organization without the prior written consent of the client.

  • The client can raise any concerns and to speak with the Therapist/Doctors immediately of any concerns provided that the Therapist/Doctors is likewise available to discuss matters with the client.

  • The scheduled termination of the therapy process will be discussed with the client beforehand, at least 2-3 sessions before the approaching the end.

  • If there is a conflict of interest, or if the Therapist/Doctors is unable to continue services for any other reason, the Therapist/Doctors will refer the client to another professional.



Emergency


Please note the services provided by Manushee are non-emergency services. In case of an emergency, please reach out to the nearest 24/7 hospital in your city. Please keep your Therapist/Doctors informed via text(WhatsApp) or email. If you are feeling suicidal, please see the list of helpline numbers available on the subsequent pages and reach out to one of them as soon as possible.



Cancellations


In case of cancellations or rescheduling a planned session, please inform the Therapist/Doctors at least 24 hours in advance.

If you cancel without adequate notice, then you agree to pay the agreed fee for the session.

THE SESSION WILL BE CONSIDERED AS A NO SHOW!

The Therapist/Doctors will also provide adequate notice in case of any changes in the schedule.



Record keeping and Confidentiality


We are committed to maintaining the confidentiality of all client information No audio/visual recording of the therapy session would be made at any point. The practitioner will however be taking and maintaining written notes during the session for future use and for record keeping.


Every personal information you share with the practitioner will be treated as privilege information. Confidentiality is your right. However, there are circumstances, in the interest of the client where it might have to be broken. Here are the possible scenarios:-

1. Threat to oneself or others. Presenting information about hurting themselves or another person. i.e. Suicidal or Homicidal thoughts and ideations

2. Evidence, suspicion or disclosure of abuse (physically, emotionally, and sexually) or neglect

3. Threats to Public Safety

4.Information is requested by a court order

5. Record Storage: Client records are stored securely and only accessible to the Therapist/Doctors.

6. Online Safety: Digital data is encrypted and stored in compliance with Indian data privacy laws ( For more information please visit Privacy Policy and Terms and Conditions section on www.manushee.com

7. All client information in such cases are need to know basis. Hence, only such information would be provided to the caregiver, authorities, required for them to take required action.

Please feel free to ask about any aspect of confidentiality during your sessions.



Disclaimer


Please read this disclaimer carefully before beginning therapy:



  • Psychotherapy is a collaborative process that supports mental and emotional wellbeing.

  • Individual results may vary based on personal circumstances and commitment.

  • Therapy is not a replacement for psychiatric or medical treatment when required.

  • The practitioner is not liable for personal decisions or actions taken outside the therapy space.

  • This service is not intended for crisis intervention. If you are in crisis, please contact emergency services or a local helpline immediately.

    • By starting therapy, you acknowledge your understanding of the above.



Fees / Self-Care Investment Policy


We believe mental health is an important investment. Our policy is as follows:



  • Session Fees: Fee details will be shared upon request by the client or can be obtained from the website under Meet The Team page for each Therapist/Doctors. Session will be confirmed only when the complete payment is received.

  • Modes of Payment: UPI, Bank Transfer, or other online payment options.

  • Updated Fees: Any changes to fee structure will be communicated ahead of time.

  • Concessions: Reduced-fee slots may be available on request, based on therapist discretion and availability. Some practitioners work with a sliding scale. The client can request the Therapist/Doctors for further details.

    • Please reach out for any questions related to payments or concessions.



Privacy Policy


Your privacy is very important to us. This policy outlines how your personal information is collected, used, and protected.



  • Information Collected: We collect personal details such as name, age, contact information, and session-related information.

  • Use of Information: Information is used solely for therapeutic purposes and practice management.

  • Storage: All records are stored securely in compliance with the Information Technology Act, 2000 and Mental Healthcare Act, 2017. Please visit Privacy section on www.manushee.com for more details

  • Disclosure: No information will be shared without your consent, except in cases of legal obligation or risk of harm.

    • If you have any questions regarding this policy, please feel free to reach out before beginning therapy or visit our Privacy and Terms and Conditions page on www.manushee.com.



Terms & Conditions


By engaging in psychotherapy sessions with us, you agree to the following terms:



  • Sessions will be conducted in a professional, ethical, and confidential manner.

  • The practitioner retains the right to discontinue therapy if deemed clinically appropriate.

  • Clients are expected to be punctual, respectful, and cooperative.

  • Services provided are not a substitute for emergency care or psychiatric intervention.

  • The client agrees to adhere to appointment and payment policies as shared.

    • These terms are in accordance with Indian professional practice guidelines and the Mental Healthcare Act, 2017.