There is a specific moment in every new practice where you take your first booking and realise you have not decided what happens if the client cancels, or what you do with their notes, or whether your insurance covers what you are about to do. The time to answer those questions is before the booking, not after.
This is Part 3 of The First Practice series.
Professional indemnity insurance
What it covers. Claims arising from your professional work — alleged negligence, harm, breach of confidentiality, or regulatory complaints. It is distinct from public liability (injury on your premises) and from cyber insurance (data breaches), and you may need all three.
What to check before buying. Territorial scope, modality cover (in-person, video, phone), client populations (adults, minors, couples — some policies exclude couples or under-18s), session types (therapy versus assessment versus supervision), and whether past work is covered retroactively.
What it costs. It varies widely by jurisdiction and caseload volume. For part-time private practice it is usually a modest annual cost; full-time practice with assessment work costs more. Treat it as a fixed overhead in your fee arithmetic.
The single most common gap. Clinicians who begin seeing overseas clients online without checking territorial scope. If your policy covers clients in your country only, a client in another country may be entirely uninsured. See telehealth across borders.
The four documents to have ready
1. Informed consent. What therapy involves, limits of confidentiality, how you handle risk, what you record, how records are stored, fees, and the client's right to withdraw. Signed before the first session, and revisited if anything changes.
2. Intake questionnaire. Presenting concerns, relevant history, cultural and family context, current supports, medications, and risk screening. Keep it proportionate — a 40-page form deters clients and gathers data you will never use.
3. Fees and cancellation policy. Your fee, session length, payment method and timing, cancellation notice period, the charge for late cancellation or non-attendance, and any exceptions for emergencies. In writing, before session one.
4. Privacy and records policy. What you collect, where it is stored, who can access it, how long you keep it, and how a client can request their records. This is also where you address third-party requests — insurers, courts, family members — and state clearly that you will not disclose without consent unless legally required.
Records: the boring part that protects you
Write notes the same day. Memory degrades fast and contemporaneous notes carry far more weight than reconstructed ones.
Store securely. Encrypted, access-controlled, backed up, and not on a personal phone's camera roll. If you use cloud software, check where the data is hosted — this matters under UK GDPR and similar regimes.
Separate clinical and administrative data. Billing systems do not need clinical detail; clinical notes do not need card numbers.
Have a deletion schedule. "Keep everything forever" is a liability, not diligence. Set a retention period by jurisdiction and apply it.
Structure and tax
Whether you practise as a sole practitioner, a partnership, or a registered company is a tax and liability question, not a clinical one, and the answer differs sharply between Nepal, India, the UK, Australia, and the Gulf. Get local advice once at the start rather than correcting it later — the cost of a single consultation is trivial compared with restructuring an established practice.
Your first-week checklist
Indemnity policy active and scope confirmed · consent form prepared · intake questionnaire prepared · fees and cancellation policy written · privacy and records policy written · secure storage set up · retention period decided · supervision arranged · emergency protocol for your client population documented.
None of these take more than an afternoon together. All of them are extremely difficult to fix retrospectively.
Our free clinician resource library includes intake, consent, fees, and policy templates you can adapt — they are a starting point for your jurisdiction, not a substitute for local review.