Informed Consent &
Therapy Agreement

Therapist Details
Name: Ms. Sanskriti (She/Her)
Designation: Counselling Psychologist / Psychotherapist
Qualification: MSc Psychology
Location: Delhi, India
Email: sanskriti125846@gmail.com
Contact Number: +91 9718212555

Purpose of This Agreement

This Informed Consent and Therapy Agreement is intended to provide clear information regarding the nature of psychotherapy, the therapeutic relationship, professional boundaries, confidentiality, fees, and policies governing therapy services.

It is designed specifically to create a safe, predictable, and mutually respectful space for our work together.

Please read this agreement carefully. If you have any questions or require clarification at any point, you are encouraged to contact me before consenting to therapy.

About the Therapist

I, Ms. Sanskriti, am a Counselling Psychologist and an American Board of Neuro-Linguistic Programming (ABNLP) certified NLP Practitioner, with over six years of academic education in the field of Psychology across India and the United Kingdom.

I hold:

an MSc in Psychology from the University of Edinburgh (UK), and
a BA (Hons) in Psychology from the University of Delhi

In addition, I have received over one year of training exposure across various mental health organisations along with over 1.5 years of experience working as a Psychotherapist at World Brain Center Hospital, Delhi.

The Therapeutic Process

Psychotherapy is a continuous and voluntary process that requires time, effort, trust, and commitment from both the therapist and the client. Meaningful therapeutic outcomes depend on consistent engagement and collaboration.

I strive to provide a non-judgemental, compassionate, and confidential space where clients feel heard, validated, and supported while working towards greater self-awareness, emotional regulation, and personal growth.

Clients are informed that therapy may at times feel emotionally challenging or uncomfortable. Such experiences are a normal and expected part of the therapeutic process and often accompany meaningful insight and change.

Special Note on Therapeutic Approach (NLP)

Neuro-Linguistic Programming (NLP), my core therapeutic modality, is a relatively newer approach within psychotherapy and offers tools aimed at facilitating significant personal change. While NLP interventions may appear more structured or directive than some traditional modalities, the choice of techniques, pacing, and treatment direction remains entirely at my professional discretion.

Therapeutic progress varies from client to client and is influenced by factors such as:

consistency in attending sessions
willingness to engage in self-reflection
compliance with therapeutic exercises and practices outside sessions

No specific outcome or timeline can be guaranteed.

Supervision Clause

As a practising therapist, I periodically engage in professional training and clinical supervision with experienced psychologists to ensure ethical practice, skill enhancement, and quality of care for my clients.

During supervision, client cases may be discussed without revealing identifying information. Client confidentiality and anonymity are strictly maintained at all times.

Privacy and Confidentiality

All information shared within the therapeutic relationship is treated with the highest level of confidentiality and professional care.

Confidentiality may be breached only under the following circumstances:

If required by law
If I believe there is a serious risk of harm to the client or others
If there is evidence of abuse, neglect, or misconduct toward any individual

Therapy sessions (online or in-person) must not be recorded in any form (audio, video, or otherwise) by either party.

I am not responsible for decisions, actions, or consequences arising from the client’s life outside the therapy space.

Contact and Availability

My working hours are 11:00 AM to 8:00 PM, Monday to Saturday (Subject to change).

Clients are requested to contact me only via WhatsApp message or email. Calls will be

returned if further discussion is required.

Clients are requested:

● not to contact outside working hours except in emergencies

● not to initiate personal contact or follow requests on my private social media accounts,

in order to maintain professional boundaries

Session Details

Each session is 60 minutes in duration.
Sessions may be conducted online (via Google Meet) or in-person, based on the client’s preference and availability.
Session fees vary depending on:
- the mode of therapy
- whether the session is an initial or follow-up session
- any bundle packages selected

Clients are responsible for joining sessions on time. Late arrival does not warrant fee reduction or extension of session time.

Session bookings may be requested via WhatsApp or email. Responses will typically be provided within 24–48 hours, subject to availability.

If a session is delayed or cancelled from my end, it will be compensated through rescheduling or time adjustment.

Session Investment

& Payment Policy

Therapy is an investment in your well-being. To maintain a smooth and professional

administrative flow, we follow a strict payment structure:

● Standard Session Fee: The investment for a standard 60-minute session (both online and offline modes) is as follows:

First Session: Rs 999/-

Second Session Onwards: Rs. 1,350/-

Offline (In-Person) Sessions: Payment can be made via Cash or UPI at the time of your appointment when you arrive.
Online Sessions: To confirm and secure your digital slot, payment must be made in advance via the official QR code shared with you. Slots are only guaranteed once payment confirmation is received.
Delayed Payments: We request that all financial dues be cleared promptly. If a payment is delayed for more than 48 hours post session, a late administrative fee of Rs. 250 will be added to your next invoice. To maintain clinical focus, subsequent sessions cannot be booked or attended until outstanding balances are cleared.

Scheduling, Consistency &

Short-Notice Requests

To ensure the highest quality of care and psychological safety, consistency is vital. I aim to

build a predictable, stable routine for your healing journey.

● The Anchor Slot (Fixed Weekly Scheduling): I highly recommend and aim to assign a fixed, dedicated day and time for your sessions each week (e.g., every Tuesday at 4:00 PM). While I understand that life happens and schedules may occasionally need to shift for both the parties, maintaining a consistent weekly slot prevents unpredictability and ensures your spot is always protected.

● Minimum Booking Notice: If you do not have a fixed weekly slot and wish to book ad-hoc sessions, a minimum notice of 24 hours is required.

● Short-Notice & Same-Day Requests: Requests for sessions made on short notice (e.g., texting in the evening for a session the next morning, or asking for same-day appointments) are strictly subject to my availability and clinical capacity. While I will always do my best to accommodate urgent needs, short-notice slots cannot be guaranteed.

Session Timings & Extensions

A standard therapy hour is micro-reserved exclusively for you. Because late endings disrupt subsequent clients and impact clinical energy, I honor strict time boundaries:

● Standard Duration: Standard sessions are 60 minutes long. A grace period of 5 minutes is natural for wrapping up.

● Involuntary Extensions: To protect my clinical capacity and ensure fairness to other clients in the waiting list, sessions must end on time. If a session inadvertently runs over by 10 minutes or more due to a late arrival or a delayed wrap-up, an additional charge of Rs. 350 will automatically apply.

● Requested Extensions: If you feel you need deeper support and wish to extend your session (subject entirely to my availability), you may explicitly request an extension at the following rates:

○ 30-Minute Extension: Rs. 675

○ 60-Minute Extension: Rs. 1,350

Cancellation and Rescheduling Policy

When you book a session, that hour is blocked out entirely for you, meaning it cannot be given to another client who might be in need. Out of respect for the therapist's time and our community, I follow a strict 12-hour cancellation window:

● More than 12 Hours' Notice: You may reschedule or cancel your session with no financial penalty.

● Late Cancellation (Less than 12 hours' notice): Cancellations or rescheduling requests made less than 12 hours before the scheduled time will incur a late fee of Rs. 500.

● No-Show (Cancellation without notice): Failing to show up for a scheduled session without any prior intimation before the session starts will be treated as a No-Show. In this case, a fee of Rs. 1,000 will be levied to cover the completely empty clinical hour.

In the event of last-minute cancellation from the therapist’s end, the client will receive an additional 10 minutes in the next scheduled session.

Termination of Therapy

Therapy is a voluntary process and may be terminated by either party at any time.

Termination may occur when:

therapy goals have been met
I determine that another professional or service would be more appropriate for the client's needs
the client’s condition requires a different level of care
Transference or countertransference is obstructing the therapist’s ability to provide objective care for the client

Appropriate referrals will be provided when necessary.

Mental Health Crisis Disclaimer

The services offered are not intended for emergency or high-risk crisis situations.

In case of immediate risk or crisis, please contact the following support services:

NIMHANS PSSMHS Helpline: 080-46110007 (24×7, toll-free)
Fortis Crisis Helpline: +91-8376804102 (24×7)
1 Life Crisis Support: 7893078930 (5:00 AM – 12:00 AM)

Informed Consent & Therapy Agreement