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Informed Consent

Protecting your privacy and the information you provide is an important principle of practice for Deborah R. Lain, and Hope for Tinnitus.  As a registered member of the College of Alberta Psychologists, Ms. Lain adheres to strict privacy and confidentiality standards. As such, all of the information you provide by phone, email, or in person is kept in strict confidence.

The information you provide will not be disclosed to any third party without your written consent except in the following extreme circumstances:

  • intent to harm myself or another
  • abuse of a minor (person under 18 years of age)
  • when subpoenaed for any information by a court of law

I agree to review the emergency resources that are available to me in my area of residence. If at any point I enter a state of crisis and am an imminent threat to myself or others, I take full responsibility for obtaining immediate and appropriate assistance as well as for any actions I may take. I understand that such situations require face-to-face intervention and accept that crisis intervention cannot be conducted online. In the event of an emergency, I agree to contact at least one of the following:

  • hospital emergency room
  • a doctor
  • crisis line or agency
  • trusted adult friend or family member

I understand that the Psychologist of Hope For Tinnitus is licensed and registered to practice in the province of Alberta since 1983.  If I reside outside of Alberta, I understand and accept to take full responsibility for informing myself of and complying with any laws regulating whom I may seek counselling from.

Please refer also to the Legal Disclaimer & Privacy Policy before signing.

I have read and understood all the information on the Hope For Tinnitus website regarding the nature of this practice.

Your Email Address
I Accept



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