Consent To Christian/Psychological Counselling Services:
What you may expect:
· To be respected and have your dignity as a person upheld
at all times.
· A counseling which deals with the entire person: Mind, Body, Emotions & Spirit.
· The right to confidentiality within certain guidelines.
· A broad based multidisciplinary approach utilizing, drawing on and informing (With consent) appropriate referring, medical & spiritual resources as well as professional supervision so that care given may extend to all of the person.
· A mixture of individual, couple, group or co-counselor therapeutic intervention.
· The right to terminate at any time and, if you choose, have your records forwarded to an appropriate care provider of your choice.
· The right to have another person present during counseling if you so desire.
· The right to disclose any and all parts of your counseling to anyone you choose.
· The right to ask for an evaluation of counseling by any qualified professional.
· The right to refuse any part of therapy.
· The right to be treated equally regardless of age, sex, race, religion or disability.
· The right to examine your counselor's provisional psychologist qualifications.
· That the counselor will seek to protect you and warn others in danger.
· That the counselor will protect life & safety before upholding confidentiality
· That the counselor will refer you if he or she is unable to meet your needs.
· That fees will be charged at current Coll. of AB. Psychologist’s rate-guides.
· A counselor who may, at his or her discretion, utilize modern video, audio or other recording technologies to treat and/or protect those involved in therapy.
What you may NOT expect:
· That confidentiality will extend to illegal, criminal,
self-mutilatory or publicly/personally hazardous actions or that the therapist will remain
silent if such has, is
or has the potential of occurring. The therapist has a duty
· That confidentiality will extend to legal or professional action against the counselor by you, on your behalf or as a result of this counseling.
· That your therapist will withhold records or testimony if called by the courts.
· That your counseling records or therapist's testimony will necessarily be useful in court for your defense or any other legal action. Records are taken for the therapist's benefit -- not the court's. (Any legal time may be billed at $500 Per. Hr.)
· That your therapist will always be available to you at any time (though every effort is made to ensure you will have resources available.)
· That the therapist will treat you contrary to his or her beliefs regarding the highest good possible in your life. (If you insist upon such, the therapist's only recourse will be to refer you to a therapist who's value system is more in line with yours.)
· That your therapist will provide you with any medications you may need.
Philosophy of care provided:
We are committed to the highest standards of care for the entire person: Mind, Emotions, Spirit and, through referral and other means, Body. We affirm the dignity, value and responsibility of every human being.
We affirm the wholeness and healing that is available to all who are willing to abandon their dysfunctional patterns and follow a different path.
We recognize that we are only one part of the care that is needed and the signing of this document constitutes formal release to consult and receive information from supervisory, psychological, medical or spiritual caregivers.
We deny that judgment and legalism have any effectiveness in the pursuit of a fully human life and affirm that the grace of God can both cover and free any person from any brokenness the human heart may experience or engage in.
Please note that any psychological counseling is subject to the above agreement and all applicable laws. This following agreement is discussed and signed prior to the commencement of counseling and it is your responsibility to inform the counselor if clarification is needed on any of the above points.
Remote video counselling services also require the completion of our Virtual Therapy Consent form and Credit Card Authorization form. To provide the highest standard of privacy currently avaliable, we exclusively promote the use of Wire for our Virtual Therapy sessions.
Please note that our office requires at least 48 hours notification of any cancelation or scheduling change. In the event that a session is missed without proper notice, we may be forced to charge for the missed session. This is not intended to be punitive in nature but, rather, is intended to ensure that those who require our services are able to access them.
For completely confidential
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(MC/Amex/Visa/Discover/Debit/Cash also accepted.)