Earth Wisdom Ecotherapy Community Interest Company

Therapy Agreement Consent Form

Please complete the form below to indicate that you have read and accept the Therapy Agreement.

Information Sharing

I confirm that I give my consent to liaise (share information about me) with the following people, if necessary, on a confidential basis.

For the Parent/Guardian

I give permission for my child to attend sessions with Earth Wisdom. I understand the nature of the sessions and give my consent for participation. I understand that basic confidentiality will be maintained, unless there is a concern about safety or harm.

For the Young Person (optional but encouraged)

I understand that I am attending sessions with Earth Wisdom to explore, learn, or receive support. I agree to take part willingly and know I can stop at any time. I know I can ask questions about what happens in the sessions.

Safeguarding and Confidentiality

Earth Wisdom is committed to safeguarding the wellbeing of young people. Information shared in sessions is kept confidential, unless there is a concern that the young person or someone else may be at risk of harm. In such cases, appropriate steps will be taken to keep everyone safe.