Agreement of Service

Agreement of Service

1. Parties and Purpose

1.1 This Agreement of Service (Agreement) is made between NeuroCog® Pty Ltd (ACN 616 441 902) trading as NeuroCog® Clinic (Clinic, we, us or our) and the person or persons identified in the Acknowledgement section of this Agreement (Client, you or your).

1.2 This Agreement sets out the terms and conditions on which the Clinic provides psychological assessment and psychotherapy services (Services) to the Client and is intended to ensure that the Client understands the nature of those Services before they commence. The Client is encouraged to raise any questions or concerns with the Practitioner before signing this Agreement.

1.3 The professional delivering Services under this Agreement (Practitioner) is a registered psychologist. The Practitioner’s background, qualifications and registration details are available at https://neurocogsystem.com/about. Clients may also verify the Practitioner’s registration with the Psychology Board of Australia at www.ahpra.gov.au.

1.4 In this Agreement, unless the context otherwise requires:

1. “AHPRA” means the Australian Health Practitioner Regulation Agency;
2. “Health Information” has the meaning given to that term in the Privacy Act 1988 (Cth) and the Health Records and Information Privacy Act 2002 (NSW);
3. “Medicare” means the Commonwealth Medicare Benefits Schedule;
4. “Privacy Policy” means the Clinic’s privacy policy as published on its website from time to time; and
5. “Session” means a scheduled appointment between the Client and Practitioner of approximately 50 minutes.

2. Nature of Services — Benefits and Risks

2.1 Psychological, Neuropsychological, Neurodevelopmental, Neurocognitive and Forensic Assessment

Psychological assessment is a structured process in which the Practitioner and Client explore personal history, developmental experiences, behavioural patterns, emotional functioning, cognitive abilities, personality characteristics, strengths, vulnerabilities, and current concerns in order to develop a comprehensive formulation and, where appropriate, diagnostic opinion.

Depending on the referral question, the Services may include psychological, neuropsychological, neurodevelopmental, neurocognitive, forensic, functional, vocational, educational, behavioural, psychosocial, risk, capacity, fitness for-purpose, treatment planning, rehabilitation, disability, medico-legal, occupational, parenting, competency, or other specialised assessments.

Assessment may involve:
clinical interviews; review of records and collateral information; psychometric testing; neuropsychological testing; neurocognitive assessment; behavioural observation; neurodevelopmental assessment; functional capacity evaluation; risk assessment; digital assessment tools; computerised cognitive testing; ecological and performance-based measures; questionnaires and rating scales; interviews with family members, caregivers, employers, teachers, health professionals, or other relevant parties.

The purpose of assessment may include: diagnosis; differential diagnosis; treatment planning; rehabilitation planning; educational accommodations; workplace accommodations; disability determination; medico-legal opinions; forensic opinions; fitness-for-duty evaluations; capacity assessments; risk management; court, tribunal, administrative or regulatory proceedings; research, training or program evaluation.

Assessment is a collaborative and evidence-based process. The scope, conclusions and recommendations of any assessment depend upon the referral question, available information, test validity, client engagement, collateral information, scientific limitations, and other relevant factors.

No assessment can provide absolute certainty or any assurance regarding future behaviour, prognosis, treatment outcomes, risk, diagnosis, legal questions, employability, parenting capacity, criminal responsibility, competency, or any other future event.

2.2 Neuropsychological and Neurodevelopmental Assessment

Neuropsychological and neurodevelopmental assessments evaluate the relationship between brain function, cognition, behaviour, emotional functioning, learning, adaptive functioning, and everyday performance.

These assessments may examine:
attention and concentration; executive functioning; working memory; processing speed; learning and memory; language functioning; social cognition; emotional regulation; sensory processing; adaptive functioning; academic achievement; intellectual functioning; developmental history; autism spectrum characteristics; ADHD symptoms; acquired brain injury; neurological conditions; neurodegenerative conditions; functional impairments.

Assessment findings may be used to guide diagnosis, treatment, accommodations, educational planning, rehabilitation, disability support, workplace modifications, and future intervention planning.

2.3 Forensic and Medico-Legal Assessments

Where Services are provided for legal, forensic, administrative, insurance, regulatory or compensation purposes, the Practitioner’s primary obligation is to provide an objective, impartial and evidence-based professional opinion.

The Client acknowledges that:

forensic assessments are not advocacy services;

opinions may not support the Client’s preferred outcome;

conclusions may be disclosed to courts, tribunals, insurers, lawyers, regulators, employers, government agencies or other authorised recipients;

the Practitioner may identify information that is inconsistent with the Client’s self-report;

findings may assist or disadvantage the Client’s legal, administrative or occupational interests.

The Practitioner cannot guarantee that any opinion will support the Client’s desired legal or administrative outcome.

Where an assessment is requested or commissioned by a third party (including a court, tribunal, insurer, employer, lawyer or government agency), the Client further acknowledges that: (a) the Practitioner’s overriding duty is to provide an objective and impartial opinion (and, where the assessment is for use in proceedings, to the court or tribunal); (b) the assessment alone does not create a treating or therapeutic relationship between the Practitioner and the Client; (c) the report will be provided to the commissioning party; and (d) the Client’s access to the report may be subject to the commissioning party’s authority and applicable law.

2.4 Psychotherapy and Psychological Treatment

Psychotherapy (also known as “talk therapy”) is a collaborative, evidence-based treatment process designed to improve emotional wellbeing, psychological functioning, behavioural health, interpersonal functioning, resilience, and quality of life.

Treatment may draw upon:
Cognitive Behavioural Therapy (CBT); Acceptance and Commitment Therapy (ACT); Dialectical Behaviour Therapy (DBT); Compassion-Focused Therapy (CFT); Schema Therapy; Motivational Interviewing; Interpersonal Psychotherapy; Trauma-Informed Therapies; Attachment-Based Therapies; Emotion-Focused Therapies; Psychodynamic Approaches; Family Systems Approaches; Integrative and Feedback-Informed Treatment models.

The Practitioner may revise diagnoses, treatment goals and intervention strategies as new information becomes available.

2.5 Neurocognitive Training and Neurodevelopmental Intervention

Neurocognitive Training (NCT) is a non-invasive neurodevelopmental intervention that utilises targeted, repetitive neurocognitive exercises designed to advance neurocognitive skills which may or may not improve: executive functioning; attention regulation; working memory; processing speed; emotional regulation; cognitive flexibility; social cognition; self-monitoring; impulse control; learning efficiency.

NCT may be delivered through specialised software platforms, digital therapeutics, clinician-guided exercises, behavioural interventions, biofeedback-informed approaches, neuroeducation, or integrated rehabilitation programs.

Theoretical mechanisms may include neuroplasticity, experience-dependent learning, cognitive remediation, skill acquisition, habit formation, and functional adaptation.

Individual responses vary substantially and outcomes cannot be guaranteed.

2.6 Functional Assessment, Rehabilitation and Capacity Building

Services may include functional assessments designed to evaluate how cognitive, psychological, behavioural, neurological, developmental or psychiatric factors affect everyday functioning.

These assessments may examine:
independent living skills; educational performance; workplace functioning; decision-making capacity; adaptive functioning; parenting capacity; social functioning; community participation; disability- related functioning; rehabilitation needs; occupational performance; fitness for work, study or specific activities.

Recommendations may include:
rehabilitation programs; workplace accommodations; educational accommodations; behavioural interventions; environmental modifications; coaching; skills training; neurocognitive training; psychotherapy; multidisciplinary referrals.

2.7 Potential Benefits

Potential benefits of assessment, psychotherapy, neurocognitive training, rehabilitation and related services may include:

1. improved self-understanding and insight;
2. enhanced cognitive, behavioural, emotional and adaptive functioning;
3. improved executive functioning, attention and self-regulation;
4. development of evidence-based treatment or rehabilitation plans;
5. improved interpersonal relationships and social functioning;
6. increased resilience, confidence and emotional wellbeing;
7. improved educational, occupational or daily living performance;
8. reduced risk and improved safety planning;
9. enhanced decision-making capacity and problem-solving;
10. support for legal, administrative, educational or occupational decision-making;
11. identification of strengths, protective factors and developmental opportunities.

2.8 No Guarantee of Outcomes

There is no guarantee that any assessment, psychotherapy, neurocognitive training, rehabilitation program, intervention, treatment recommendation or professional opinion will achieve any particular outcome.

The Client acknowledges that outcomes depend on numerous factors including:
client engagement; motivation; treatment adherence; environmental circumstances; developmental factors; neurological factors; medical conditions; family systems; social supports; educational and occupational opportunities; the nature and severity of presenting concerns.

2.9 Potential Risks and Discomfort

Participation in assessment, treatment, rehabilitation or neurocognitive training may involve discomfort including:

1. recalling distressing memories, experiences or emotions;
2. experiencing sadness, anxiety, anger, grief, shame, frustration or emotional vulnerability;
3. confronting maladaptive beliefs, behaviours or coping strategies;
4. temporary increases in emotional distress during treatment;
5. fatigue associated with cognitive testing or neurocognitive training;
6. receiving information regarding diagnoses, impairments, risks or limitations;
7. forensic, legal, educational, occupational or administrative consequences arising from assessment findings;
8. mandatory reporting obligations where required by law;
9. disagreement with assessment findings, recommendations or professional opinions.

2.10 Client Responsibility

The Client acknowledges that decisions regarding personal relationships, legal matters, employment, education, finances, medical treatment and implementation of recommendations remain the Client’s responsibility except where the law authorises another person to make those decisions on the Client’s behalf. The Practitioner does not provide legal, financial or general medical advice, and the Client should obtain advice from an appropriately qualified professional before making decisions of that kind.

The Practitioner provides professional opinions and recommendations only, and cannot control how those opinions or recommendations are interpreted, applied or relied upon by any third party. To the maximum extent permitted by law (including the Australian Consumer Law), the Clinic is not responsible for any decision made, or action taken, by a third party in reliance on the Practitioner’s opinions or recommendations.

3. Couples and Relationship Counselling

3.1 This clause 3 applies only where the Practitioner and Client have agreed that the Services will include couples or relationship counselling.

3.2 Where the Client is a couple or relationship unit, the primary focus of the Services is the relationship, with both partners as equal participants. The Practitioner will endeavour to maintain impartiality between the partners at all times.

3.3 Confidentiality in couples counselling. All information disclosed within sessions is confidential and will not be revealed to the other partner, or to any third party, without the express permission of the person who disclosed it, except where disclosure is required or permitted by law. The mandatory reporting and other exceptions to confidentiality described in clause 4 apply equally to couples therapy.

3.4 Disclosure policy. At the commencement of couples therapy, the Practitioner and clients will agree on a disclosure policy. The Practitioner will not disclose to one partner information provided by the other partner in an individual session unless that partner has authorised such disclosure. Partners are strongly encouraged to make significant disclosures only within scheduled couples sessions and with the guidance of the Practitioner. Disclosures made outside of sessions without the Practitioner’s guidance are strongly discouraged and may disrupt the therapeutic process.

3.5 Individual sessions within couples counselling. Occasionally, individual sessions with one partner may form part of the couples counselling. Information disclosed in such individual sessions is treated as part of the couples counselling. Where information disclosed individually is relevant to
the treatment of the relationship, the Practitioner will encourage the disclosing partner to share that information with their partner at an appropriate time and will provide structured guidance for doing so (Formal Disclosure). Formal Disclosures are carefully structured and proceed only when the
disclosing partner has consented.

3.6 Court proceedings. The parties acknowledge that the purpose of couples or relationship counselling is to support the health and wellbeing of the relationship. Information obtained during counselling is not intended for use in legal proceedings between the parties. The Practitioner will not voluntarily provide records or testimony in any legal proceedings between the parties without the written consent of both parties, and will assert any applicable privilege unless compelled by a court order or legal obligation to disclose.

3.7 Release of records. Records relating to couples counselling will only be released with the written consent of both partners, except where the Practitioner is required by law to release records.

4. Confidentiality

4.1 Information disclosed by the Client in the course of the professional relationship is confidential and will not be disclosed to any third party without the Client’s written authorisation, except as provided in this clause 4.

4.2 The Practitioner is subject to the following mandatory disclosure obligations under Australian law, which apply irrespective of the Client’s wishes or directions:

1. mandatory reporting of child abuse or neglect under the Children and Young Persons (Care and Protection) Act 1998 (NSW) or equivalent legislation in the applicable jurisdiction;
2. reporting obligations under the Mental Health Act 2007 (NSW) or equivalent legislation where the Client poses a serious and imminent risk of harm to themselves or to an identifiable third party;
3. mandatory reporting obligations under the Health Practitioner Regulation National Law (NSW) in respect of registered health practitioners who engage in notifiable conduct; and
4. disclosure required by a court order, search warrant or subpoena.

4.3 The exceptions described in clause 4.2 represent the Practitioner’s primary mandatory obligations as they exist at the date of this Agreement. Mandatory reporting obligations may change from time to time. The Client is encouraged to contact the Psychology Board of Australia on 1300 419 495 or the OAIC for further information about their rights.

4.4 The Practitioner may discuss the Client’s case with other treating health professionals or seek clinical, ethical or legal consultation as part of their professional and legal obligations. In such consultations, no personally identifying information will be disclosed without the Client’s express written consent.

4.5 All information held by the Clinic about the Client constitutes Health Information and is managed in accordance with the Clinic’s Privacy Policy, the Privacy Act 1988 (Cth) and the Health Records and Information Privacy Act 2002 (NSW). A copy of the Privacy Policy is available on the Clinic’s website.

5. Records and Record-Keeping

5.1 The Practitioner will create and maintain clinical and business records in relation to the Client’s engagement, including notes made during or after sessions. Such records are created and maintained in accordance with the Practitioner’s professional and legal obligations.

5.2 Clinical records are the property of the Clinic and are held on behalf of the Client. The Practitioner will maintain records in accordance with their professional obligations and will not alter records at the request of any Client.

5.3 The Client has the right to request access to their clinical records. Such a request must be made in writing to the Clinic. Access will be provided in accordance with the Clinic’s obligations under the Privacy Act 1988 (Cth) and the Health Records and Information Privacy Act 2002 (NSW). The Clinic may provide a treatment summary in lieu of full clinical records where clinically appropriate. Records may be transferred to another treating health care provider with the Client’s written consent.

5.4 Clinical records will be retained for a minimum of seven years from the date of the last entry, or in the case of a child Client, until the Client turns 25 years of age or for seven years from the date of last entry, whichever is later. This is consistent with the Clinic’s obligations under applicable legislation and professional standards. Records will be destroyed in a secure manner that preserves the Client’s confidentiality.

6. Client Litigation and Subpoena

6.1 The Practitioner will not voluntarily participate in any litigation or custody dispute in which the Client is a party, including by providing written reports, declarations, affidavits, letters or testimony, except where required by law.

6.2 The Practitioner will not communicate with the Client’s legal representatives or provide materials for use in legal proceedings involving the Client, except where required by law or with the Client’s prior written consent.

6.3 If the Practitioner is required by subpoena or court order to attend legal proceedings, produce records or give evidence in connection with the Client’s matter, the Client agrees to reimburse the Clinic for the Practitioner’s reasonable costs, including preparation time and travel time, at the Clinic’s then-current forensic rate (currently AUD$300 per hour). The Client will be notified of the applicable rate before any such attendance is required.

6.4 The Client agrees and acknowledges that information disclosed in the course of treatment may be subject to professional privilege, the scope and application of which depends on the nature of the proceedings and the applicable law. The Client should and is strongly encouraged to obtain independent legal advice about the existence and scope of any privilege before putting their mental or emotional state in issue in any legal proceeding, as doing so may constitute a waiver of privilege.

7. Fees and Payment

7.1 The fees for each consultation session range from $0 (under Medicare Bulk Billing) to $300 per session for approximately 50 minutes. The applicable fee is determined by reference to the experience and professional registration level of the relevant practitioner.

7.2 The Client is responsible for payment of all fees. The Clinic reserves the right to adjust fees from time to time. The Client will be given at least 14 days’ written notice before any fee adjustment takes effect. If the Client does not accept a fee adjustment, the Client may end the engagement under
clause 10.3 before the adjustment takes effect, and no cancellation fee will apply to any Session not yet held.

7.3 Where the Client is eligible for Medicare rebates or private health fund benefits in connection with the Services, the Client is responsible for understanding and managing their own entitlements. The Clinic does not guarantee any particular level of rebate.

7.4 Fees may be varied by agreement in writing between the Client and the Clinic, or by the terms of any applicable Medicare, private health, Department of Veterans’ Affairs, Department of Communities and Justice , workers’ compensation or other third party payor arrangement. Where the Client’s fees are covered in whole or in part by a third party, the Client remains personally liable for any fees not paid by that third party.

7.5 From time to time, the Practitioner may engage in electronic contact (including without limitation, telephone calls, message service and email) with the Client for purposes other than scheduling sessions. The Client is not charged for email exchanges of no more than 200 words or telephone calls of less than five minutes per week. If this threshold is exceeded, additional charges may apply at the applicable Session fee rate, calculated pro rata, and the Client will be notified before any such additional charges are incurred. This includes contact with third parties at the Client’s request with the Client’s prior written authorisation.

7.6 Payment is due at the time of each Session unless otherwise agreed in writing. The Clinic accepts payment by:

1. cash;
2. credit card/debit card; and
3. electronic fund transfer (EFT) to the Clinic’s designated bank account.

Outstanding fees may be referred to a collection agency if not paid within 90 days of the due date, and the Client acknowledges that the Clinic may disclose the Client’s contact details and the amount of the outstanding debt to a collection agency for this purpose.

8. Cancellation Policy

8.1 The Client is responsible for and shall be liable for payment of the full Session fee in respect of any Session that is missed without notice, or for which the Client fails to provide at least 48 hours’ prior notice of cancellation.

8.2 Notice of cancellation must be provided by email to [email protected] or by voicemail on +61 2 8224 9670. The time of receipt of the notice will determine whether the 48-hour’s prior notice requirement has been met.

8.3 The Clinic acknowledges that genuine emergencies and circumstances beyond the Client’s control may arise. In such cases, the Clinic will exercise reasonable discretion in applying its cancellation policy, and the Clinic’s determination shall be final. The Client must notify the Clinic as soon as practicable if they are unable to attend a Session for such reasons and provide any information reasonably required by the Clinic in assessing or exercising its discretion.

8.4 Cancellation fees are not claimable under Medicare or private health insurance.

9. Practitioner Availability and Crisis Services

9.1 The Practitioner’s office is equipped with a confidential voicemail system. The Client may leave a message at any time. The Practitioner will endeavour to return calls within 48 hours or by the next business day, but this cannot be guaranteed.

9.2 The Client acknowledges that the Practitioner does not provide 24-hour crisis services. If the Client is experiencing a mental health crisis or requires immediate assistance, the Client should:

1. call Triple Zero (000) for emergency assistance;
2. attend the nearest hospital emergency department;
3. contact Lifeline on 13 11 14 (available 24 hours);
4. contact the Suicide Call Back Service on 1300 659 467; or
5. contact Beyond Blue on 1300 22 4636.

9.3 To the greatest extent permitted by law, the Clinic is not responsible and will not, in any way, be liable for any harm arising from the Client’s failure to seek emergency assistance when required.

10. Ending Engagement

10.1 The Clinic may terminate the provision of Services at any time on reasonable grounds including the following circumstances:

1. non-payment or consistent late payment of fees;
2. failure to comply with treatment recommendations or to actively participate in the therapeutic process;
3. the existence of a conflict of interest that prevents the Practitioner from acting in the Client’s best interests;
4. the Client’s needs falling outside the Practitioner’s scope of competence or practice; or
5. the Client not making adequate progress, such that continuation of treatment would not be in the Client’s best interests.

10.2 Where the Clinic terminates Services, it will, to the extent practicable:

1. give the Client written notice;
2. provide a closing session where clinically appropriate;
3. offer referrals to other suitable practitioners or services; and/or
4. cooperate with the Client’s transition to a new treating practitioner, save and except that the Clinic is not required to provide a closing session is for non-payment or consistent late payment of fees where the termination is for non-payment or consistent late payment of fees under clause 10.1(a).

10.3 The Client has the right to end engagement at any time. Upon doing so, the Practitioner will, to the extent practicable:

5. recommend at least one cessation session to facilitate a positive conclusion to engagement; and
6. offer referrals to other practitioners if appropriate.

10.4 Upon cessation of the professional relationship by either party, the Client’s obligation to make full payment for any Sessions already attended, the cancellation fee as set out in clause 8 (if any), and the confidentiality obligations and other rights and obligations expressed to survive termination,
remain in full force and effect.

11. Professional Consultation

11.1 The Practitioner may, as part of their professional and ethical obligations, seek clinical, ethical or legal consultation from appropriate professionals in connection with the Client’s treatment. In such consultations, the Practitioner will not disclose personally identifying information about the Client without the Client’s express written consent.

12. Acknowledgement and Client Consent

12.1 By signing this Agreement (whether by physical signature, electronic signature or entry of the Client’s name in the designated field), the Client acknowledges and agrees that:

1. the Client has read and understood this Agreement in its entirety;
2. the Client has had an opportunity to discuss the terms of this Agreement with the Practitioner and to ask questions;
3. the Client consents to the Clinic providing the Services described in this Agreement;
4. the Client consents to the collection, use and disclosure of their Health Information in accordance with the Clinic’s Privacy Policy and as described in clause 4 of this Agreement;
5. the Client is financially responsible for all fees payable under this Agreement, including any fees not reimbursed by Medicare or a third-party insurer; and
6. the Client has not been provided with any guarantee as to the outcome of the Services.

12.2 Electronic acceptance of this Agreement is valid and binding. An electronic record of the Client’s acceptance constitutes a legally effective signature for the purposes of this Agreement.

12.3 The Client may withdraw consent to treatment at any time by notifying the Practitioner in writing. Withdrawal of consent will not affect any financial obligations already incurred.

13. General

13.1 Governing law. This Agreement is governed by the laws of New South Wales, Australia. Each party submits to the non-exclusive jurisdiction of the courts of that State.

13.2 Limitation of liability. To the extent permitted by law, including the Australian Consumer Law (Schedule 2 to the Competition and Consumer Act 2010 (Cth)), the Clinic’s aggregate liability to the Client for any claim arising out of or in connection with the Services is limited to the total fees paid by the Client to the Clinic in the three months preceding the event giving rise to the claim. Notwithstanding anything to the contrary stipulated in this Agreement, nothing in this Agreement limits or excludes any liability that cannot be limited or excluded under the Australian Consumer Law, including any applicable consumer guarantees.

13.3 Consumer guarantees. The Australian Consumer Law implies certain guarantees in respect of services supplied to consumers that cannot be excluded. If the Client is a “consumer” as defined in the Australian Consumer Law, nothing in this Agreement excludes, restricts or modifies any consumer guarantee that applies to the supply of Services.

13.4 Non-excludable health practitioner liability. Nothing in this Agreement limits or excludes the Practitioner’s liability for death or personal injury caused by the Practitioner’s negligence, for fraud or fraudulent misrepresentation, or for any other liability that cannot be excluded under applicable law.

13.5 Entire agreement. This Agreement, together with the Clinic’s Privacy Policy, constitutes the entire agreement between the parties in relation to the provision of Services and supersedes all prior representations, negotiations and agreements.

13.6 Severability. If any provision of this Agreement is held to be invalid or unenforceable, that provision will be severed and the remaining provisions will continue in full force and effect.

13.7 Variation. This Agreement may only be varied by written agreement signed by both parties.

13.8 Waiver. No failure or delay by a party to exercise any right or remedy under this agreement constitutes a waiver of that or any other right or remedy. A waiver is only effective if given in writing and signed by the waiving party, and applies only to the specific instance for which it is given.

13.9 Complaints. If the Client has a complaint about the Services or the conduct of the Practitioner, the Client is strongly encouraged to raise it with the Clinic in the first instance. If the Client is not satisfied with the Clinic’s response, the Client may lodge a complaint with the Psychology Board of Australia (via AHPRA) on 1300 419 495 or at www.ahpra.gov.au.

17.9 Counterparts
These Terms may be accepted electronically and the electronic record of your acceptance constitutes a binding counterpart for the purposes of these Terms.