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Consent Form

I consent to a secure electronic and/or paper record being kept of:

  • My name, date of birth, and contact details
  • Basic content of sessions only

General Data Protection Regulations (GDPR) Privacy Statement
Records held by Dr John Ashfield are subject to the General Data Protection Regulations 2018, which give clients/supervisees the right to access personal data held about them.Your data are strictly private unless your life or the life of another is at risk, if there is a safeguarding issue, or you are involved in a crime. In these cases, we may be obliged to contact emergency services or relevant authorities without your permission.
I understand that my data will not be shared with anyone else (except for reasons stated above), will be used for reference by the practitioner only, and will be destroyed 12 months after sessions conclude.

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Name
I understand that my data will not be shared with anyone else (except for reasons stated above), will be used for reference by the practitioner only, and will be destroyed 12 months after sessions conclude.