This Informed Consent Form explains your rights, responsibilities, and the nature of psychotherapy. By beginning therapy with Healing with Mayank, you acknowledge that you understand and agree to these terms.
Psychotherapy is a collaborative process that may involve discussing emotions, relationships, thoughts, past experiences, and coping patterns. At times, sessions may bring up difficult feelings — this is normal and part of the healing process.
Sessions are conducted by a trained, certified mental health professional who follows ethical standards and maintains confidentiality as required by law and professional guidelines.
Everything you share is confidential except when:
There is risk of harm to you or someone else
There is suspected abuse or exploitation of a minor, elder, or vulnerable person
A court order requires disclosure
You provide written permission
Digital communication (email/WhatsApp) may have limited privacy; secure platforms are used wherever possible.
Individual psychotherapy
Couple therapy
Short-term follow-up sessions
Psychoeducation and referrals as needed
Healing with Mayank does not provide emergency or crisis services.
You agree to:
Attend sessions regularly and on time
Communicate honestly to the best of your ability
Inform the therapist of any medication or health changes
Respect the cancellation policy
Your therapist will:
Offer ethical, culturally sensitive, and trauma-informed care
Maintain confidentiality within legal limits
Provide referrals when appropriate
Inform you of any changes in scheduling or availability
Individual sessions: 50 minutes
Short follow-up sessions: 30 minutes
Couple therapy: 90 minutes
Sessions begin and end on time, regardless of late arrival.
Fees must be paid before or at the start of each session (depending on chosen mode). No refunds are offered once a session begins.
More than 24 hours: No fee
Less than 24 hours: Full session fee applies
No-show: Full session fee applies
Repeated cancellations or no-shows may affect continuation of care.
By choosing online therapy, you acknowledge:
A stable internet connection is required
Sessions may shift to audio if video fails
You will ensure privacy during your session
Teletherapy has limitations and may not be suited for all situations.
Healing with Mayank does not provide crisis intervention.
For emergencies, contact:
Emergency Number (India): 112
KIRAN Mental Health Helpline: 9152987821
Your nearest hospital emergency room
Therapy may conclude when:
Your goals are met
You choose to end the process
The therapist recommends referral
Attendance becomes irregular
A final closure session is recommended.
By attending sessions, you agree that:
You have read and understood this form
You have had the opportunity to ask questions
You consent voluntarily to participate in psychotherapy with Healing with Mayank