**Please Note that it is not recommended to share detailed personal mental health information via this form due to:
(A) possible privacy risks when using any technology, such as email/text (e.g., security breaches);(b) if you disclose to a staff member that there is a risk of potential harm to self or others, as we may need to disclose your personal information to other professionals in order to alert others/arrange for outside help to attend to those who may be in distress or who we believe could be at risk for harm;(c) you are not yet considered to be a client/customer of the centre as no formal agreement has been put in place and we have yet to confirm everyone’s understanding of what is being consented to, including your privacy limits;(d) correspondence to/from staff may need to be kept (e.g., filed electronically) and if stored, likely for at least 11 years;(e) you have not yet been informed of Nova Scotia laws regarding how long client files are kept when sexual violence has been recorded in the file – so we do not recommend sharing any information on this form related to the above (e.g., abuse /assault) until you have been informed of your privacy rights via consent form/service contract.
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