Statement of Confidentiality
Counseling Services adheres to strict confidentially guidelines set by APA and ACA ethical standards. All conversations, both by telemental health and in person, shall be held in strict confidence. Also, all records kept by the counselor relating to the client and issues discussed by the client during counseling sessions, shall be held as confidential, except under the following conditions:
– When the counselor considers the client to be a threat to himself/herself, or to another individual or individuals;
– When the counselor regards the client as committing any type of physical or sexual abuse toward a child or elderly person;
– When documents are court ordered to be released to the property of the court;
– When a counselor deems it necessary to engage in professional consultation with another counselor regarding a particular client and/or case.
Refusal to Harm
The client agrees that he/she will not physically harm self or others. If the client believes to be a threat to himself/herself or others, for reasons beyond control, the client agrees to notify emergency personnel at 911, go to the nearest ER or consult a crisis line by phone or text.
Print and fill out this form: Counseling Intake Form