Disclaimer and Consent

IN PERSON

In Person Sessions Available.  30 minute minimum. 

TELEPHONE OR EMAIL COUNSELING
Payment is made by paypal or by mail (check or money order) before the counseling session begins, and after the confirmation. When confirmation is made the session will be scheduled.  If you must cancel your session, advance notice must be provided so that we may reschedule your appointment, otherwise, you will forfeit your prepayment.

Counseling will not exceed the pre-arranged appointment time. The counselor will inform when you are nearing the end of the session. You are free to schedule other session/s after making your first appointment.

The benefit of telephone or email counseling is complete privacy and safety because you are in the convenience of your own home.  The service is easily accessible and very cost effective. 

Total Living Comfort reserves the right to deny services to an individual whose concerns are beyond the capacity of this ministry to effectively treat, or who fails to follow procedures.

CONFIDENTIALITY
The counselor will take notes during the session for personal use only, and not for any other purpose. However, by state law, a counselor, pastor, or psychologist is legally required to share certain information with the appropriate authorities if the counselor learns of a crime about to be [or having been] committed; or certain information dealing with an abusive situation, for the protection of the victim in such situations. Failure to make such legally required disclosure will be a violation of the law.

DUTY TO WARN AND PROTECT

If the client discloses, shows a sign of being suicidal, or implies a plan for suicide, counselors are required to take reasonable means to try to prevent this from occurring. If a client discloses intentions to harm another person, counselors are required by law to warn the intended victim and/or report this information to legal authorities.

PARENTAL PERMISSION
You must be over 18 years of age in order to utilize our services. If you are under 18, then your custodial parent or guardian MUST contact us on your behalf. We absolutely must have parental permission.

MENTAL HEALTH SERVICES

Our services are not intended to replace direct healthcare from a mental health professional. You must contact mental healthcare professional directly in order to determine the seriousness of your condition in order to determine if it could be related to physical or medical causes that might require in-person care.

If you decide to utilize information or services offered by Total Living Comfort Counseling Services, instead of or in addition to direct in-person care from a mental health or medical professional, we cannot be held liable for any adverse outcomes because you failed to follow our advice in this regard.

MEDICATION

If you take any medication or natural or herbal supplement, ask your doctor or pharmacist about potential side effects or medication effects that could be responsible for any symptoms you are experiencing.

TRUTHFULNESS AND HONESTY

Your information is presumed to be factual and true.  Any responses or recommendations that we make to you shall be based upon information that you supplied.  We cannot be held liable for any omissions or misrepresentations on your part or any unfortunate outcomes that may be associated with inaccurate or incomplete information.

I have read and understand the above terms and hereby give my consent for counseling.

Name:

Address:

Phone Number:

Email Address:

Date: