Informed consent

By booking an appointment you hereby declare that you belong to one of the following four categories:

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1. you have the legal responsibility of the minor involved, whom you give informant consent for, which includes guardianship, adoption, parental responsibility, shared parental responsibility and being in ‘loco parentis

2. you are 18 years old or above and capable of providing an informed consent.

3. you are under the age of 18 and you affirm that you have obtained the informed consent of your legal guardian. By doing so, you confirm that your legal guardian is aware of the appointment and has given their written consent for your participation (eg. by using this form). 

4. you are an emancipated minor.

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You agree to have understood the nature of the proposed psychological service, benefits and risks of the proposed psychological service which may include, but not limited to: improved mental health, higher mental proficiency, increased focus, increased attention threshold, enhanced responses, symptom relief; parents can gain insight and skills to improve their relationship with their child and to better manage their child's behavior(s). Parents and/or the child might experience uncomfortable feelings due to the discussion about the child’s/family's difficulties. It may also require recalling unpleasant aspects of the parents' or child’s past or present situation.

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By giving your consent you also agree that under no circumstances you will deem Lotus Psychotherapy or its staff responsible for physical injures due to patient's self-harm, uncontrollable behavior, or unpredictable body responses, which is entirely under the responsibility of the consent giver.