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Female Patient

Client Resources

Confidential Client Information Form / Privacy Notice

Below you will find your 'new client information' form to complete and submit when we have agreed to work together or when we have requested further information prior to our first online session. Please do not complete this form until we have spoken - initial enquiries should be made by phone or the 'enquiry form' on the contact page.


If there are any questions that you would prefer not to answer at this stage, then simply leave the field blank, although the more detail you can provide the easier it will be to make an accurate assessment of the therapy required. Thank you. Also below, you will find the GDPR Privacy Notice relating to how we hold your information.

New Client Information Form

Please complete and submit. Strictly confidential

Thanks for submitting. I look forward to working with you to improve your health and wellbeing.

Privacy Notice

Privacy Notice

I collect personal information from you as part of my client induction process. In handling this information, I am bound by two sets of rules, the General Data Protection Regulations (GDPR) and my professional body's code of ethics. This page will explain how these affect the way I work.


  • I am both the Data Controller and the Data Protection Officer. My contact details are: Andrea Holbrook, email, phone 07919 056142.

  • The information about you that I collect comes from you, via direct conversations, email correspondence and agreement form (either online or on paper)

  • You have no legal requirement to share information with me, but if you do not I will not be able to offer you my services

  • The purpose of collecting personal information from you is to enable me to decide if I can offer you my therapy services, to administer the therapy programme once you are enrolled, to enable me to invoice you and receive payment, and to provide you with information via email

  • The categories of data/information I collect include: your name and contact details, your payment preferences, your medical history, your therapeutic issues, case history and ongoing treatment records

  • You give me permission to hold and use this information in line with these guidelines when you apply for therapy services

  • I keep the information you give me for seven years after your treatment finishes, which is the length of time suggested by my professional body and insurance company for client records

  • Sharing your information: I do not share your information

  • My professional body's code of ethics also allows me to share anonymous case histories verbally or in professional publications for the purposes of supervision or training. Anonymous means your personal details are removed and no information that might identify you is used.

  • I only divulge sensitive information where there is a legal requirement for me to do so e.g. where the Children's Act applies or a court order is issued, or when there is good cause to believe that if I do not disclose information you or others would be exposed to a serious risk of harm.


You have rights over the information I hold about you. These are:

  • Portability - you can ask me to send your information to someone else

  • Rectification - if you think my records are wrong you can ask me to change them

  • Erasure - in some circumstances you can ask me to remove your details from my records (this is sometimes called 'the right to be forgotten')

  • Fair profiling - you can ask that any processes I automate are done by a person instead of a computer. I don’t currently automate any information processing, although I may use online forms to collect information.

  • Right of access - you can have a copy of the information I hold at any time, by requesting it in writing. If you do this it will be provided within 30 days and free of charge.

  • Restricting processing - in some circumstances you can request that I stop processing your information

  • Objection - you can object to the way I process information (e.g. if it is used to send you direct marketing and you don’t want to receive this) and can ask me to stop using it in this way

  • Information - you have the right to understand how I collect and process your information (hence this privacy notice)


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