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New Leaf Counselling & Psychotherapy Consent to Service

This document contains important information for clients and parents/guardians.
Please read and ensure your thorough understanding prior to completing and submitting.
Please submit after you have scheduled your first session with Catherine and prior to that session. 


consent to Psychological Treatment with Catherine June Paul, M.A., RP (Registered Psychotherapist - Ontario, Canada Registration # 006637) to provide counselling and psychotherapy to me or my child/ward.


Limits of Confidentiality

Confidentiality is respected at all times.

Exceptions to confidentiality include the legal and/or ethical obligations for your therapist to: 

  • Inform a potential victim of a client’s intention to harm;

  • Inform an appropriate family member, health care professional, or police if necessary of a client’s intention to end his or her life

  • Release a client’s file if there is a court order to do so

  • Inform the Children’s Aid Society if there is suspicion of a child being at risk or in need of protection due to neglect, or physical, sexual or emotional abuse

  • Report a health professional who has sexually abused a client.

In Case of Emergency

Emergency services are not available. In case of emergency, clients should contact their family practitioner, or go to the nearest emergency department of any hospital.

Authorized Consent

Thanks for submitting!

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