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confidentiality

CONFIDENTIALITY

By signing this form, I consent that Jo Dakin may release information to a specific individual or agency if it has been determined that a vulnerable person (child or elder) is at risk; if I, as a client, am in imminent danger to myself or others; or if a subpoena of records has been requested.

 

I also understand that, at any time, Jo Dakin may discuss aspects of my case with other colleagues keeping my full name and identity completely confidential always unless I have given permission otherwise.

 

 


 

Full Name:    _________________________    Signature: _____________________________
 

Date:             _________________________

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Jo Dakin

Integrative Life-Coach & Therapist

Boostas Coaching

West Parley, Dorset

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Tel: +44 (0)7774-279413

boostas121@gmail.com

© 2024 by Boostas Coaching. 

Boostas Group Ltd 15539454

Impowerz is a trading name of Boostas Group Ltd

Or for queries fill in the form below, and I will get back to

you as soon as I can.

Thanks for your enquiry!

Look forward to speaking with you soon!

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