Counselling agreement and privacy notice
Please read through the Counselling Agreement and the Privacy Notice below, then if you’re happy with those, please complete this form.
Thank you and I look forward to speaking with you.
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Information about private phone and video counselling: how I work
I work as a private practitioner offering online therapy via video and phone from my practice in Alsager, Cheshire. I work within the code of ethics of my professional body, the National Counselling and Psychotherapy Society, (NCPS) of which I am a Professional Accredited member (membership number. NCS23-00122).
At our first session, we will talk about your reasons for considering counselling and how we might work together, then together we can decide if are a good fit and if counselling with me is the right path for you. If we go ahead, we will review our work every six sessions or so, although many people find they don’t need as many as six sessions. If we decide we’re not a good fit, I may be able to signpost you to another counsellor or organisation.
Confidentiality and Data Protection
Our conversations are confidential except in certain situations: I may discuss some of our conversations and our work together (but not your identity) with my supervisor as required by the NCPS code of ethics; if I am concerned for your safety or someone else’s, I may contact your GP or another appropriate person/organisation; there may be a legal requirement to disclose certain information, e.g., a serious crime.
I keep brief notes of each session as an aide memoire. These are stored securely, and separately from your name and contact details, in accordance with UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018.
You may have a copy of these notes if you wish. They are destroyed after our work together is completed and after any insurance company time frames have elapsed. More detail is in my Privacy Notice, which is at the end of this document.
Session format
Each session usually lasts for one hour, and times will be as arranged between us. For phone appointments, I will usually call you at the agreed time but if you’d rather call me, that’s fine, just let me know in advance. If the call doesn’t connect, or connects and then fails, I will call you back (if you’ve called me, I’ll wait for you to call me back). If we can’t reconnect again within 10 minutes, I’ll contact you to rearrange.
Also for your confidentiality, if you don’t have a safe private space to talk when our phone or video session begins, please let me know and we can rearrange if necessary.
For video calls I will open the Zoom room within 5 minutes of the appointment time. If you have difficulties connecting, please phone or text so we can resolve or find a workaround.
Fees and payment terms
Session fees are set for 2026 at £50 per one hour session. This will be reviewed no more frequently than annually, and clients will be given at least 2 months’ notice of any fee increase. Any issues relating to an increase in fee can be discussed to find a suitable accommodation.
Sessions will usually be booked online and fees paid at the time of booking.Cancellation and refund policy
If you have to postpone or cancel a session, please give at least 24 hours’ notice, otherwise the fee for that session will normally be payable. This is because that time is set aside for you and cannot usually be offered to someone else at very short notice. I will usually send a confirmation the day before, but please do not wait for me to do that if you already know that you won’t be able to make the session.
I am happy to refund fees for sessions cancelled with more than 24 hours’ notice.
Contact between sessions
If you need to contact me between sessions, please text on 07581 069877, or email cm@counsellorcrewe.co.uk, or leave a voicemail or voice note. I will reply as soon as possible but please be aware that it may not be immediate. I don’t offer support between sessions, but we can arrange another appointment as soon as possible, if you wish. (Please note: I do not provide a crisis service. If you are experiencing a mental health emergency, please contact your GP, call 111, or reach out to the Samaritans on 116 123. For more information see my crisis support page.)
Ending counselling
If you decide you no longer want counselling, please let me know this, you don’t have to say why unless you want to. If anything is getting in the way of you coming, we may be able to find a way round it. If there is a gap of 3 months since our last session, I may contact you to confirm for my records if our work together is complete.
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Click to read moreabout how Caroline Midmore Counselling collects, stores, and protects your personal data in line with UK GDPR and the Data (Use and Access) Act 2025.