CLINICAL SESSION APPLICATION FORM

Application Details

Participant Profiles

Please complete and elaborate the information in the following section(s), for the Creative Arts Therapist to adequately understand the Client’s needs.

Programme Schedule

A clinical cycle includes 8 consecutive weekly sessions.
Regular attendance is an important factor in fostering therapeutic effectiveness.
Please provide a date at least 1 month from today.
A continuous period of 10 weeks should be available from the commencement date.

Programme Logistics

Characteristics of a conducive programme space:
  • An enclosed space to protect the privacy of the client(s).
  • Tables and chairs that allow sufficient space for each client (e.g. two persons per classroom-sized table).
  • A non-carpeted floor to allow the use of art materials such as paints.
  • A sink within the room or nearby.
  • Secure storage for artworks and art materials during the programme period that is not freely accessible (e.g. a locked cabinet or opaque A3-sized storage boxes).

Please ensure the venue is open for Creative Arts Therapists to enter for preparation and clean-up at least 30 minutes before and after each session.

Billing Details

Agreement to Terms and Conditions

By checking this box, the applicant confirms agreement to the Terms & Conditions outlined below. Please review them carefully.

Terms & Conditions for Clients

Administrative Matters
  • The Client confirms that all information provided in the Needs Assessment Form (NAF) is accurate and complete. All personal information shared will be kept confidential.
  • By submitting Contact Person details, the Client confirms that consent has been given for The Red Pencil (Singapore) (RPS) to contact these individuals in emergencies related to the programme.
  • Upon receipt of the completed NAF, RPS will commence the process of matching the Client with a suitable Creative Arts Therapist. This process typically takes approximately one (1) month.
  • The Client agrees to complete any required pre-programme and post-programme forms requested by RPS.
Safety of Client
  • In matters of immediate safety, the Client, Caregiver, or Referrer should contact the Police at 999 or the Singapore Civil Defence Force ambulance service at 995.
  • For urgent emotional or psychological support, the following services may be contacted:
    • Institute of Mental Health – Mental Health Helpline: 6389 2000 (24-hour)
    • Samaritans of Singapore: 1767 (24-hour hotline) / 9151 1767 (CareText WhatsApp)
    • Tinkle Friend: 1800 2744 788
    • CHAT, Centre of Excellence for Youth Mental Health: 6493 6500
    • Women’s Helpline: 1800 777 0000 (Weekdays, 10am – 6pm)
  • The Client, Caregiver, or Referrer must promptly inform RPS of any physical or psychological safety concerns.
  • A change of Creative Arts Therapist will only be considered in cases involving safety concerns or professional misconduct.
Fees & Payment
  • All programme fees, including art materials, shall be borne by the Client unless otherwise agreed in writing with RPS.
  • Payment shall be made directly to “The Red Pencil (Singapore)” upon receipt of invoice.
  • Full payment must be made before the first session. Instalment arrangements may be made prior to the first and fourth sessions.
  • Delayed payments may result in sessions being suspended.
  • Submission of false or misleading information may render the Client liable to repay any financial assistance granted.
  • RPS is not obliged to provide reasons for acceptance or rejection of financial assistance applications.
Rescheduling Policy

To ensure effectiveness and continuity of Creative Arts Therapy, Clients are encouraged to adhere to scheduled sessions wherever possible. All rescheduling requests are subject to the availability of the assigned Creative Arts Therapist.

Notice time given for change request Document to justify the need for a reschedule Rescheduling
At least 24 hours before session Not required Sessions may be rescheduled up to two (2) times per programme cycle, subject to therapist availability. Further rescheduling requires a valid justification document.
Within 24 hours and at least 2 hours in advance of session Available Session may be rescheduled.
Not available The session will be deemed utilised. No make-up session will be provided, and the Client will be liable for the full session fee with no refund.
Within 2 hours of session Not applicable