
Mental Health Brief Intervention Service
(Virtual HIP Information and Consent)
You have been referred by your usual GP for Virtual HIP sessions. Please take the time to read the Patient Information sheet.
Once you have finished reading the information sheet, submit the consent form below. The booking platform will open in a separate tab.
Patient Information Sheet
Kia ora,
You have been referred by your GP or Nurse to see a virtual Health Improvement Practitioner (HIP), or have self-referred as part of your ongoing health care. The HIP is employed by Auckland PHO (the Primary Health Organisation your general practice belongs to).
What is a HIP?
A HIP is a qualified health professional trained to support people with a wide range of concerns affecting their mental, physical, or emotional wellbeing.
The HIP service is a free and confidential health and wellbeing service available by Phone, Virtual Appointment (via Microsoft teams) or in-person.
To ensure you understand the nature of this service and your rights, we ask that you read and consent to the following terms before meeting the HIP.
Confidentiality and Privacy
I understand that what I discuss with the virtual HIP is confidential and will be treated in accordance with:
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The Privacy Act (2020);
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The Health Information Privacy Code (2020);
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Auckland PHO policies and procedures;
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The professional and ethical standards of the virtual HIP’s regulatory body.
However, I understand that confidentiality may be broken if:
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I disclose an intention to harm myself or someone else;
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There is a legal obligation (e.g., a court order) requiring information to be shared;
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An audit is conducted by Auckland PHO or a relevant professional body on the practitioner I see.
I understand that in any situation where there is concern for safety, the HIP may contact my GP, nurse practitioner or any organisation necessary to ensure my safety or the safety of others (Police, Mental Health Crisis Teams). I will be informed if such an action needs to be taken (where possible).
Session Notes and Communication
I understand that:
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Brief notes from my HIP session(s) will be recorded in my general practice health record;
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These notes may be accessed by my GP, Nurse Practitioner, or other members of my healthcare team at my general practice;
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Notes from my HIP sessions are also stored on Auckland PHO’s secure management system called Kotahi. Access to these records is strictly limited to authorised Auckland PHO staff who require the information for service quality, reporting, or clinical-governance purposes. These notes are not visible to other practices or external agencies without consent, except where required by law;
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These records are stored securely and are used to ensure continuity of care.
Session Structure and Attendance
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I understand that HIP sessions are typically brief and focused and may include up to 2–3 follow-up appointments, depending on my needs. There is no cost to these appointments.
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If I cannot attend a session, I will aim to notify the HIP as soon as possible;
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I understand that repeated non-attendance without notice may result in the conclusion of virtual HIP support.
Recording of Sessions
I understand that the use of recording devices (e.g., audio or video) during HIP sessions is not permitted, unless explicitly agreed upon in writing by both me and the HIP.
Consent
When making a booking for this service through Auckland PHO’s portal, I confirm by making an appointment and ticking the appropriate box that:
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I understand the role of the Health Improvement Practitioner;
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I have had any questions or concerns addressed to my satisfaction;
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I consent to receiving support through this service and understand the conditions outlined in this document.
Understanding My Rights
As a consumer of health services in Aotearoa New Zealand, I am protected under the Code of Health and Disability Services Consumers’ Rights.
Concerns or Complaints
If you have any concerns or feedback about your experience with the Health Improvement Practitioner (HIP) service, please contact Auckland PHO or the Health & Disability Commissioner.
Your Safety
The contact numbers and email addresses and links contained in this document are not for acute, urgent, emergency, or crisis services for health or mental health.
Auckland PHO is not a medical service, and these numbers and email addresses are not monitored.
If you are concerned about the safety or wellbeing of yourself or someone else, and believe they require immediate assistance, please contact 111 for emergency services or your local Mental Health Urgent Response Service Team (Crisis Team).
Please note: Auckland PHO oversees and supports the delivery of the HIP service but does not provide clinical care directly. The email address that this information is sent from is not monitored for emergency/urgent or clinical matters and is checked during regular business hours only.
