I have been informed of the purpose of the career counselling service with the Employee Assistance Program (EAP) and agree to communicate with the career counsellor. These are one-on-one meetings with the client and the counsellor only. I acknowledge that I must be alone in the room, and/or have headphones on.
The career counsellor informed me of the purpose of our communications, their role, the approach and the tools they use. They also explained the limitations of their interventions and the alternatives available.
● Cancellation Policy: I can cancel or reschedule any session up to 4 hours in advance. I will be charged a $25 fee for any late requests or missed appointments. I understand that Dialogue reserves the right to cancel my appointment if I am more than 5 minutes late, if my environment is not safe or private, or if communication is not secure.
The process and the content discussed during my online meetings will remain confidential. I have been informed that an electronic file will be kept on a secure server. I am aware of the confidentiality of the data related to the information technologies used during our meetings.
● Technological issues and risks: If communication via video camera is not possible or interrupted due to technical difficulties, the session may be conducted by telephone. Exchanges will be conducted exclusively on the Dialogue platform. I acknowledge that, despite my service provider's best efforts to ensure high encryption and secure technology, there is no guarantee that unauthorized people cannot access my personal information.
I am aware that the orientation process that I begin with my counsellor is confidential. In this sense, none of the information exchanged during this process will be shared without my consent
● My geographic location must always be disclosed so that the counsellor can confirm that they are not engaging in an illegal practice due to licensing restrictions.
I consent to undertake this counselling process and I know that I can withdraw this consent if I wish.
You are receiving this consent form because of the regulations surrounding the profession of career counsellor in Quebec.
Membership in the Ordre professionnel des conseillers et conseillères d'orientation du Québec (OCCOQ) is mandatory to use the title of career counsellor in Quebec. For more information on ethics and public protection, see the following links:
●Code of Ethics for Career Counsellors in Quebec
●Information for the public
●Regulation on the conciliation procedure and arbitration of members' accounts