Social Work Services Intake & Consent

Nature and Purpose of Social Work Services

Social Work Services at Your Counselling Ltd. are collaborative, practical, goal-oriented, and focused on improving individual well-being by addressing barriers related to financial, housing, family, legal, health, and community systems.

Depending on your identified needs and the social worker’s professional scope, services may include:

• Biopsychosocial assessment and intake;
• Case management, service coordination, and system navigation;
• Advocacy and coordination with community or professional supports;
• Assistance with forms, applications, referrals, and documentation;
• Psychoeducation, problem-solving, and brief emotional support; and
• Identification of additional services or referrals that may be helpful.

Social Work Services are not a replacement for psychotherapy, medical care, psychiatric care, or legal advice. If psychotherapy or another professional service is indicated, you may be referred to an appropriate provider, including a therapist within Your Counselling Ltd. where appropriate.

Scope and Limitations of Service

Social Work Services are generally time-limited and goal-based, with the nature and duration of service determined by the client’s identified needs and the agreed-upon scope of work.

After the initial intake assessment, you and your social worker will identify the priorities to be addressed, the agreed scope of work, and the next steps. Goals and service needs may be reviewed and updated as the work progresses.

Our social workers can provide information, guidance, advocacy, and support when navigating external systems. However, Your Counselling Ltd. and its social workers cannot guarantee eligibility, approval, funding, placement, legal outcomes, or decisions made by external organizations, programs, government bodies, insurers, or other service providers.

The social worker may provide advocacy and practical assistance but does not make decisions on your behalf or control decisions made by external systems. Your participation may be required to complete applications, provide information or documents, communicate with third parties, or take agreed next steps.

The quality and effectiveness of the service depend on the accuracy and completeness of the information you provide. The social worker may request supporting or verifiable documentation when needed for advocacy, applications, or documentation. You are responsible for reviewing completed documents for accuracy before they are submitted or relied upon.

Confidentiality

Information shared as part of Social Work Services is treated as confidential and will not be disclosed without your consent except where disclosure is required or permitted by law or professional obligations. Limits to confidentiality may include circumstances involving a serious risk of harm, suspected or confirmed abuse or neglect where reporting obligations apply, a valid court order or subpoena, or other legal requirements.

Listing a person, professional, agency, or organization on this intake form does not by itself authorize Your Counselling Ltd. or your social worker to disclose information to them. Where communication or coordination with a third party is needed, appropriate consent will be obtained before information is disclosed, unless disclosure is otherwise required or permitted by law or professional obligations.

Your social worker may also participate in professional consultation to support sound decision-making and quality of care. Whenever possible, consultation uses non-identifying information, and those involved are bound by applicable confidentiality, privacy, ethical, and professional obligations.

Clients’ Rights

You have the right to ask questions about the service, the social worker’s role, recommendations, documentation, fees, and any proposed course of action. You may decline a recommendation or request clarification or alternatives. You may also request a referral when another service or provider would better meet your needs. You may discontinue services at any time. Discontinuing services does not remove responsibility for fees already incurred or other outstanding financial obligations.

Respectful Communication and Conduct

Your Counselling Ltd. is committed to providing a safe, respectful, and professional environment for clients, practitioners, administrative staff, contractors, and visitors. We recognize that clients may be navigating stressful or difficult circumstances and encourage questions, concerns, and feedback.

Abusive, threatening, harassing, intimidating, discriminatory, or aggressive communication or behaviour will not be tolerated. This expectation applies to in-person, telephone, email, text, virtual, social media, and other interactions with the practice.

Where concerns arise, the practice may take reasonable steps based on the circumstances, seriousness of the behaviour, and any safety or professional-boundary concerns. These steps may include pausing or limiting communication, requiring written correspondence, ending an interaction, cancelling or rescheduling appointments, suspending or terminating services, and/or providing referral options where appropriate.

Outstanding fees remain payable.

Record Keeping and Documentation

Your Counselling Ltd. maintains demographic and administrative information such as contact details, appointment history, billing information, consent forms, and other non-clinical documentation. The treating social worker maintains professional records relating to the services provided, in accordance with applicable legislation, regulatory standards, and professional obligations.

Records are maintained in secure digital systems using appropriate safeguards and are retained for a minimum of seven (7) years following the final service, or longer where required. Documentation is concise and relevant to the professional service provided. Requests for records, summaries, letters, or other documentation are subject to privacy requirements, professional standards, consent requirements, and applicable fees.

Contacting Your Social Worker

For scheduling, billing, or administrative matters, please contact the Client Services Team. Social workers may not be immediately available by telephone and are not a crisis service. Voicemail or email messages sent directly to a social worker are generally reviewed and responded to within two business days. Email and voicemail should not be used for urgent or crisis matters. If the social worker will be unavailable for an extended period, alternate contact information may be provided for time-sensitive matters.

Emergencies

Your Counselling Ltd. and its Social Work Services are not emergency or crisis services. If you require immediate assistance, call 911 or attend the nearest Emergency Department or Urgent Care Centre. In Calgary, you may contact Distress Centre Calgary at 403-266-4357. In Dartmouth and surrounding areas, you may contact the Mental Health Crisis Line at 1-888-429-8167. Across Canada, you may call or text 988 for 24/7 suicide crisis support.

Questions, Concerns, and Feedback

Questions about the professional service provided by your social worker should be discussed directly with the social worker whenever possible. Administrative matters—including scheduling, billing, clinic policies, and documentation requests—should be directed to the Client Services Team. Where a concern relates to professional conduct, ethics, or standards of practice, Client Services can provide information regarding the appropriate regulatory body and complaint process.

Consent

By signing below, you confirm that you have read and understood the information above, have had an opportunity to ask questions, understand the nature and limitations of Social Work Services, and consent to receive Social Work Services from Your Counselling Ltd.

Fees are payable in accordance with the service arrangement. Debit, credit, cash, and e-Transfer are accepted. Detailed receipts are provided following payment.

Where direct billing is available, Your Counselling Ltd. cannot determine or guarantee your insurance coverage. Any amount not covered by direct billing remains the client’s responsibility and is payable in accordance with clinic policy.

Reduced Fee Programs: Fees may be reduced where a client is participating in an approved Your Counselling Ltd. reduced-fee program. Any reduced fee, eligibility requirements, terms, and conditions will be outlined in a separate agreement. Where a separate reduced-fee agreement is in place, the fee specified in that agreement will apply instead of the standard rate listed above.

Follow-Up and Re-Service Policy

Unless an error was made by the social worker in the initial work, follow-up, revision, appeal, re-service, or additional advocacy requests are billed at the applicable service or documentation rate. For example, if an external application is denied and you request assistance with an appeal or additional documentation, the additional time required is billable.

Appointments are reserved exclusively for you. When an appointment is cancelled with short notice or missed, it is often too late to offer that time to another client.

• A full 24 hours’ notice is required for all appointment cancellations and changes.
• Cancellation is not complete until confirmation is received from the booking system or Client Services Team.
• Appointments cancelled with less than 24 hours’ notice are billed at 100% of the scheduled service fee.
• Missed appointments/no-shows are billed at 100% of the scheduled service fee.
• Appointment reminders are a courtesy. Clients remain responsible for keeping track of their scheduled appointments whether or not a reminder is received.
• Cancellation fees are waived only in limited circumstances, including a documented medical emergency requiring urgent professional treatment, a death in the family, or unsafe travel conditions such as a severe snowstorm.
• If your most recent appointment in a series is missed or cancelled late, associated fees must be paid within 24 hours to retain remaining pre-booked appointments.
• For more than two future appointments, a credit card on file is required. The card will only be charged in accordance with the applicable cancellation/payment policy.
• Late-cancellation and no-show fees cannot be submitted or direct billed to insurance as a completed Social Work Service.
• Weekend appointments must be cancelled by the Friday before the appointment.
• Clients with overdue balances may be unable to book or retain future appointments until the account is resolved.
• Unpaid accounts may be referred to a third-party collection agency.
• Online scheduling may be unavailable at the practice’s discretion or because of program requirements, outstanding invoices, or a pattern of frequent cancellations, changes, or no-shows. Where online booking is unavailable, appointments must be arranged through Client Services.

Fee Agreement

By signing below, you confirm that you have read, understood, and agree to the fee, appointment, cancellation, missed appointment, and payment policies above.