Psychotherapy Services Agreement & Practice Policies

Last Updated: September 2026

These Terms of Service apply to psychotherapy services provided by Stephanie Annesley, Registered Psychotherapist (Qualifying) (“I,” “me,” “my,” or “the therapist”).

These Terms are intended to explain the administrative, technological, and business terms associated with accessing my services. They work together with my Informed Consent Agreement, Privacy Policy, and any other consent or practice documents provided to you.

Professional Status

Psychotherapy services are provided by Stephanie Annesley, Registered Psychotherapist (Qualifying), a registrant of the College of Registered Psychotherapists of Ontario (CRPO).

The title Registered Psychotherapist (Qualifying) reflects my current registration category with CRPO. I practise in accordance with the professional standards, ethical requirements, and applicable legislation governing Registered Psychotherapists in Ontario.

As a Registered Psychotherapist (Qualifying), I practise with clinical supervision as required by CRPO. Information about my registration status can be verified through CRPO's Public Register.

IMPORTANT EMERGENCY INFORMATION

My practice is not an emergency or crisis service and is not monitored 24/7.

If you are in immediate danger or require urgent medical assistance, call 9-1-1 or go to your nearest emergency department.

If you are in Canada and you are thinking about suicide or are concerned about your ability to stay safe, you can call or text 9-8-8 to reach the Suicide Crisis Helpline.

If you are outside Canada, please contact the emergency or crisis services available in your current location.

Do not rely on email, online booking, website forms, portal messages, or other communications with my practice for emergency assistance.

1. Agreement to These Terms

These Terms apply when you use my online practice systems or receive services from me, including through Jane App or another approved platform used for:

• booking and managing appointments;

• completing intake or consent forms;

• attending virtual psychotherapy sessions;

• processing payments;

• receiving secure communications; and

• accessing resources related to your care.

By booking an appointment, submitting forms, or indicating your agreement electronically, you acknowledge that you have received and reviewed these Terms.

Your consent to psychotherapy is separate from your acceptance of these Terms. Psychotherapy will only be provided after appropriate informed consent has been obtained, and consent remains an ongoing process throughout therapy.

You may ask questions about these Terms or your psychotherapy services at any time.

2. Eligibility and Consent to Services

My practice currently provides individual psychotherapy to adults aged 18 and older.

By accessing services, you confirm that:

• you are at least 18 years old;

• the information you provide is accurate to the best of your knowledge;

• you will provide information reasonably necessary for the safe and appropriate provision of services; and

• you will notify me of relevant changes to your contact information or location.

If another person is legally authorized to act on your behalf, their involvement will be handled in accordance with applicable consent, capacity, privacy, and health-care laws.

3. Psychotherapy Services

I provide individual psychotherapy within my professional scope of practice, competence, and registration requirements.

Depending on your needs, services may include:

• psychotherapy;

• assessment within the psychotherapy process;

• collaborative treatment planning;

• psychoeducation;

• therapeutic interventions and strategies;

• referrals or recommendations to other professionals or services when appropriate.

The specific approach used in therapy will depend on your needs, goals, preferences, and my professional judgment and scope of competence.

Psychotherapy is collaborative and individual experiences vary. Specific results or outcomes cannot be guaranteed.

Informational Resources

Any worksheets, guides, educational materials, website content, or other general resources I provide are intended for educational or informational purposes unless specifically incorporated into your psychotherapy.

General educational information is not a substitute for individualized medical, psychological, psychiatric, or other professional care.

4. Informed Consent

Before beginning psychotherapy, you will be provided with information reasonably necessary to make an informed decision about participating in therapy.

This may include discussion of:

• the nature and purpose of psychotherapy;

• the therapeutic approach or methods being considered;

• potential benefits;

• material risks or possible adverse experiences;

• reasonable alternatives;

• the potential implications of choosing not to proceed;

• fees and relevant practice policies;

• confidentiality and its limits; and

• considerations specific to virtual psychotherapy.

You are encouraged to ask questions at any time.

Consent is an ongoing process, not a one-time form. You may decline a proposed intervention, ask questions, request changes, or withdraw your consent to psychotherapy at any time.

If there is a significant change in the therapeutic approach or services being provided, this will be discussed with you as appropriate.

5. Location and Virtual Practice

Psychotherapy services are provided virtually.

At the beginning of virtual appointments, you may be asked to confirm your current physical location. This information may be necessary for safety, emergency planning, insurance, legal, and regulatory purposes.

I can only provide psychotherapy when doing so is consistent with:

• my CRPO registration and professional obligations;

• applicable laws and regulatory requirements;

• professional liability insurance requirements; and

• any applicable requirements in the jurisdiction where you are physically located at the time of the session.

If you plan to attend a session while travelling or while physically located somewhere different from your usual location, please let me know before the appointment whenever possible.

Depending on your location, I may need to determine whether I am permitted and appropriately insured to provide services to you from that jurisdiction.

If services cannot legally, ethically, safely, or appropriately be provided while you are in a particular location, we may need to reschedule the appointment or discuss alternative supports.

6. Virtual Therapy and Technology

Virtual psychotherapy involves benefits as well as limitations and potential risks.

Possible risks include:

• internet or technology interruptions;

• unauthorized access despite reasonable safeguards;

• reduced privacy if you participate from a location where others can hear or see you;

• limitations in responding to emergencies remotely; and

• communication misunderstandings that may occur through electronic technologies.

I take reasonable steps to use technology that is appropriate, secure, and suitable for providing psychotherapy.

You are responsible for taking reasonable steps to protect your own privacy during sessions, including using a private location and a secure device and internet connection where possible.

Technology Failure

If a virtual session is interrupted by technical difficulties, we will attempt to reconnect.

If reconnection is not possible, we may use an agreed-upon backup communication method or determine whether the appointment should be rescheduled.

7. Electronic Communication

Email, text messaging, online forms, and portal messaging may be used for administrative purposes where appropriate.

Electronic communications can carry privacy and security risks. Sensitive clinical information should generally be communicated through the secure methods identified by the practice whenever reasonably possible.

Electronic communication is not monitored continuously and should not be used for emergencies or urgent mental-health concerns.

Relevant treatment-related communications may form part of your clinical record.

8. Privacy and Confidentiality

Your privacy and confidentiality are important components of psychotherapy.

Your personal information and personal health information will be collected, used, disclosed, stored, retained, and protected in accordance with applicable privacy legislation, professional requirements, and my Privacy Policy.

Where applicable, this includes Ontario's Personal Health Information Protection Act, 2004 (PHIPA).

Information you share in psychotherapy is confidential except where disclosure is:

• authorized by you;

• permitted or required by law; or

• otherwise necessary or permitted under applicable professional and legal obligations.

The specific limits of confidentiality, including circumstances involving mandatory reporting or legally required disclosure, will be explained as part of the informed consent process.

Additional information about how personal health information is handled is available in my Privacy Policy.

9. Clinical Records

A clinical record will be maintained regarding the psychotherapy services provided to you.

The record may include information such as:

• identifying and contact information;

• consent documentation;

• assessments;

• treatment or therapy plans;

• progress notes;

• appointment information;

• relevant communications;

• referrals and consultations;

• financial information; and

• information relating to the conclusion of therapy.

Where I am the health information custodian, records will be retained for at least 10 years following the last interaction with you, or as otherwise required by applicable law and CRPO standards.

You may have rights to access or request correction of your personal health information, subject to applicable legal exceptions.

10. Fees and Payment

Current fees are communicated before services are provided and are available upon request.

You agree to pay the applicable fee for services you receive.

A valid payment method may be required to remain securely on file through the payment platform used by the practice.

By providing payment information, you authorize payment to be processed for services provided and for other charges you have agreed to, such as applicable late-cancellation or missed-appointment fees.

You will be informed of changes to therapy fees before the new fee applies.

Receipts will be provided for psychotherapy services. You are responsible for confirming whether services are eligible for reimbursement through your private insurance or benefits provider.

11. Cancellations and Missed Appointments

At least 24 hours' notice is requested when cancelling or rescheduling an appointment.

Appointments cancelled with less than 24 hours' notice and missed appointments may be charged up to the full scheduled session fee.

Late-cancellation or missed-appointment fees may be waived or adjusted where appropriate based on the circumstances.

Any applicable cancellation fees form part of the practice's fee schedule and will be communicated before services begin.

12. Insurance and Third-Party Reimbursement

I do not guarantee that psychotherapy services will be reimbursed by your insurance provider, employer benefit plan, or another third party.

Coverage varies between plans.

You are responsible for confirming your coverage, including whether your plan covers services provided by a Registered Psychotherapist (Qualifying).

Receipts will accurately identify the service provided and the treating therapist's applicable professional information.

13. Ending Psychotherapy

You may choose to stop psychotherapy or withdraw your consent to treatment at any time.

I may recommend or initiate discontinuation of services when doing so is professionally appropriate, including where:

• your needs fall outside my scope of competence;

• another type or level of care would be more appropriate;

• psychotherapy is no longer clinically appropriate or beneficial;

• there are circumstances affecting my ability to provide services safely or appropriately;

• the practice is closing or changing in a way that affects your care; or

• agreed-upon payment obligations have not been met.

I will not discontinue services on grounds prohibited by applicable human-rights legislation.

When I initiate the discontinuation of psychotherapy, I will consider your circumstances, communicate the reason for discontinuation where appropriate, and make reasonable efforts to support continuity of care, including providing appropriate referral options when you wish to continue treatment.

The conclusion of services and relevant recommendations or referrals will be documented in your clinical record.

14. Complaints and Concerns

If you have a concern about your services, you are welcome to raise it with me directly.

You are not required to resolve a concern with me before contacting the College of Registered Psychotherapists of Ontario (CRPO) or another body that has jurisdiction over the matter.

Information about CRPO's complaints process is available directly from the College of Registered Psychotherapists of Ontario.

Privacy concerns may also be raised with the appropriate privacy authority where applicable.

Nothing in these Terms limits any right you may have to make a complaint to CRPO, a privacy regulator, or another regulatory or legal authority.

15. Third-Party Technology

My practice may use third-party service providers for functions such as scheduling, videoconferencing, payment processing, record management, or electronic communication.

I take reasonable steps to select and use technologies appropriate for handling confidential information and providing psychotherapy.

However, no electronic system can be guaranteed to be completely free from technical failures or security risks.

Your use of third-party platforms may also be subject to the provider's own terms and privacy practices.

16. Professional Judgment and Outcomes

Psychotherapy is individualized, and responses to therapy vary.

No particular result, improvement, timeframe, diagnosis, or outcome is promised or guaranteed.

Clinical recommendations and therapeutic approaches are based on the information available, your individual circumstances, my professional judgment, and my scope of competence.

Where another professional or service may be better suited to your needs, this may be discussed with you and a referral may be recommended.

17. Limitation of These Terms

Nothing in these Terms is intended to:

• waive or limit your rights under applicable health-care, privacy, consumer-protection, or other legislation;

• waive or limit my professional obligations as a registrant of the College of Registered Psychotherapists of Ontario;

• prevent you from making a complaint to CRPO or another regulatory authority; or

• exclude liability that cannot legally be excluded or limited.

To the extent that these Terms conflict with applicable legislation, regulations, CRPO standards, or other binding professional obligations, those requirements will take precedence.

18. Changes to These Terms

These Terms may be updated periodically to reflect changes to the practice, technology, legislation, or professional requirements.

If a change materially affects your psychotherapy services, privacy, fees, or other terms relevant to your care, you will be informed as appropriate and any additional consent required will be obtained.

19. Governing Requirements

My professional practice is governed by the professional requirements applicable to me as a registrant of the College of Registered Psychotherapists of Ontario, together with applicable legislation.

Other legal or regulatory requirements may also apply depending on the jurisdiction in which services are provided or where you are physically located.

20. Acceptance

By electronically accepting these Terms, you acknowledge that you:

• have had an opportunity to review them;

• understand that you may ask questions about them;

• understand that these Terms are separate from the ongoing informed-consent process for psychotherapy; and

• agree to the administrative and practice terms described above.

Your acceptance of these Terms does not waive any rights you have under applicable law or the professional standards governing psychotherapy services.