In compliance with the GDPR which came into force on May 25th 2018

Data Protection Information and Consent Form

The changes in Data Protection legislation that come into force on 25th May 2018 legally oblige me to pro-vide you with the following information, and to ask you to give your consent for me to hold your personal data.

What is included under “personal data”?

The personal data I hold about you may include:

• Your phone number, email address, postal address.

• Emails and email attachments, SMS messages we have exchanged.

• The intake form / questionnaire which you have completed at the beginning of our work together.

• Brief notes for each session.

How do I store your personal data?

• Your contact details and other personal information you provided in the intake form are stored securely in a locked filing cabinet [OR stored electronically on my PC / hard drive etc as an encrypted, password-protected file].

• Your phone number is stored on my mobile phone under your first name or initials (no surname is used), as are any SMS/Whatsapp messages and record of phonecalls. My phone is code-locked and is kept se-cure at all times.

• Our email correspondence is password-protected and my email service provider ensures that the emails are secure and encrypted.

• Brief session records are kept as hard copy in a locked filing cabinet [OR, kept in an encrypted, password protected file on my PC etc] and do not contain your name/other personal details but are coded for ano-nymity. These are kept separately from your intake form that contains your personal details.

• Audio/video files are encrypted and password-protected and do not contain your name/other personal details in the file title.

• Appointments are booked in my diary with your first name only.


Why do I need to hold your personal data?

• In order to be able to communicate with you via phone, email or post if necessary.

• So that I have a record of your attendance and a note of important factual information that may be of significance in our work together.

• For purposes of supervision/mentoring which is a professional requirement for me as a therapist/EFT Practitioner.

• To ensure that, if I find that there is serious risk to you, or a vulnerable person / child, I could take appro-priate safeguarding action.

• It is a requirement of my insurance provider, Balens Insurance Ltd

How long will I keep your personal data for?

• My insurance provider, requires me to keep any client records for 7 years after completing therapy or, if you are under 18 at the time of therapy, for 7 years after you reach 18.
• After 7 years from completion of our work together, all electronic data will be permanently deleted, and any hard copies shredded and disposed of.

Your right to see the personal data I hold about you

• The legislation states that you have the right to see the personal data I am holding about you.

• If you wish to do so, you can ask to see your personal data verbally or in writing, and I will be required to provide this for you within 30 days of your request.

When may I share your personal information with third parties?

There is a limited number of circumstances in which I may share your personal data and other information with third parties:

• Where required by a court of law.

• If your safety or that of a vulnerable adult or child is imminently at risk.

• If you request and/or give me consent to share your information with another health professional for the purposes of improving your care.

• As required by my professional code of conduct I may discuss some aspects of my client work (anony-mised, i.e. only your first name is ever used) with my supervisor/mentor who is an experienced thera-pist/practitioner also bound by the rules of confidentiality, with the usual exceptions.


I have read and understood the above information, and agree for my personal data to be held and processed by Dr Carl Stonier in the ways and for the purposes described above.

Name ……………………………………………………………………………………………



Signature ……………………………………………………………………………………..



Date …………………………………………………………………………………………..
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