Confidentiality Agreement

Counseling involves sharing sensitive, personal, and private information that may at times be distressing. Please do take note that during the course of counseling, there may be periods of increased anxiety or confusion. All interactions with the therapists/counselors, including scheduling of or attendance at appointments, the content of your sessions, progress in counseling, and your records are CONFIDENTIAL. No record of counseling is contained in any academic, educational, or job placement file. You may request in writing that the counseling staff release specific information about your counseling to persons you designate.

Exceptions To Confidentiality:

• Your therapist may consult with her Supervisor to provide the best possible care. These consultations are for professional and training purposes.
• If there is evidence of the clear and imminent danger of harm to self and/or others, the therapist/counselor is legally required to report this information to the authorities responsible for ensuring safety.
• A court order, issued by a judge, may require the therapist/ counselor to release information contained in records and/or require the therapist/counselor to testify in a court hearing.

As counseling services are based on client and counselor collaborative agreement. There is a standard fee charged to the client for counseling services. There could be a possibility that you are referred to other rehabilitation, addiction center, or substance abuse professionals.

I have read and discussed the above information with my therapist. I understand the risks and benefits of counseling, the nature and limits of confidentiality, and what is expected of me as a client of the Counseling Services.