Client Consent

By signing below, I consent to Juanitte Pieterse, Counselling Psychologist and Psychotherapist and Reinard Barnard, Kinesiologist and Personal Trainer, the Health Care Practitioners at Strong for Life Integrative Psychological Therapy, and/or their designated Administrator may process my personal data in accordance with the following legitimate reasons for processing and/or using my personal data:

1. Upon my consent, I understand that my personal information will only be used for the purpose for which it was collected, that the information will be retained for a period of time that is necessary and required by law, I am entitled to view the information at any time and to request the correction or deletion of my personal information held by the Practice.
2. I understand that I may withdraw my consent at any time by using the relevant Data Subject Consent Withdrawal Form.
3. Hereby, I consent to the Health Care Practitioner collecting and using my personal information.
4. The Health Care Practitioner has my express consent to collect and process my information for the purposes of providing me with psychotherapeutic services.
5. I expressly consent to the Health Care Provider submitting any outstanding accounts to a third-party debt collection agency.
6. The Health Care Practitioner and his/her/their Administrative Staff have my express consent to accessing my personal information contained in my health record, which may include clinical notes for processing medical documentation, or performing any other administrative function as requested by my Health Care Practitioner.
7. It is my express consent to the Health Care Practitioner to use my personal information to contact me in person, by telephone, by email, by video call, by fax, by WhatsApp, or by any other method.
8. It is my express consent that my Health Care Provider may disclose relevant personal health information to the Management Group or Society to which it belongs to enable them to provide administrative services including coding queries, billing issues, and audit assistance.
9. It is my express consent that the Health Care Practitioner may disclose any of my personal health information to any other member of the Therapeutic Team who may provide me with health care services throughout the course of my treatment, and to provide such information to referring health care practitioners.