- rarchuletta05@gmail.com
- 970-682-4042
Privacy Statement
This is to inform you what data I am collecting from you and what I intend to do with it.
What data do I keep and why do I need it?
Name and age – this is basic information that helps me get to know you.
Address, email address, phone number – I use this as a way of contacting you regarding your sessions. I will mainly use the method you first contacted me on but if I cannot reach you, I will try a different method.
Next of kin/medical professional’s details – If I was worried that you were at risk then I may need to contact your next of kin or medical professional, if I can. I will let you know when/if I am going to do this.
Session notes – I keep brief notes of our session(s), [add in a description of how these are kept].
Will I share your data and if I do, who will I share it with and for what purpose?
It is very unlikely that I will share your data. I will not sell it on or use it for unethical reasons. I may have to share it if my notes are subpoenaed by court, if you or anyone you tell me about is at harm or risk of harm, I may have to pass this information on.
How will I store your data?
Example text: It is mainly stored as hard copy in a locked filing cabinet. Immediately after the work is finished, I transfer the data with your initials to my password protected computer. Your phone number(s) may be kept in my business mobile phone with your first name and last initial. Only I will access your information.
How long will I store your data for and how will I dispose of it?
I will keep your details and session notes for the time required by my insurer. After this time, I will destroy any document with your personal information and delete your phone number out of my mobile phone.
Consent
I consent to my data being used as set out above.
Therapist signature:
Client signature:
Date: