Informed Consent for Consultation with Dr. DeeAnna Merz Nagel
Clinical consultation includes: Case Consultation for Coaches, Therapists and other Holistic Practitioners I understand that these consultations do not constitute clinical supervision and that I remain completely
responsible – ethically and legally – for the decisions I make in my own clinical case situations. My consultant will provide me with an opportunity to discuss clinical cases and issues about which s/he may have some expertise, and s/he may help me consider options for responding, but the comments made for my consideration are not supervision or practice management mandates.
I also understand that although we may sometimes need to discuss personal issues that may be relevant to my clinical work, these consultation services do not constitute psychotherapy.
I understand the potential limits of the confidentiality of this relationship. To the extent possible, my case presentations will provide no identifiable patient information. However, I understand that if I provide identifiable information about a situation regarding which my consultant has an ethical or legal obligation to report confidential information, s/he will inform me at the time and will give me the opportunity to make the report myself.
I understand that if my consultant becomes aware that s/he knows or has a prior relationship with the presented client(s), or if she believes she has a potential conflict of interest in her relationship with me, she will notify me of that fact immediately and will cooperate in helping me find a different consultant.
Professional consultation includes but is not limited to:
- Integrating Holistic Practices (aromatherapy, energy healing, intuition)
- Marketing Strategies
- Clinical Case Consultation
- Supervision of Supervision
- Telemental Health
- Required Student Consults following completion of a course with Dr. Nagel
Consultant agrees to provide services that are consistent with experience, education and qualifications. Curriculum Vita available here: https://deeannamerznagel/about-deeanna/cv/
Signed & Dated:
(Agreeing to Terms of Service per Doxy satisfies this requirement)