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KARIS COUNSELLING SERVICES

COUNSELLING CONTRACT

Counselling will address issues of the whole person, which may include the areas of the emotional, volitional, behavioral, and spiritual aspects of your life. The likely benefits of counselling are the development of a healthier life-style and healthier relationships. You have the right to request that your counsellor explain any part of the counselling process to you.

The counsellee is free at any time to seek other counselling assistance or to not seek any more counselling help without counsellor prejudice. Other counselling options, if any, will be provided at the counsellee’s request. The counsellor or counsellee has the right to terminate the counselling process upon serving reasonable notice and supplying grounds for termination.

Unidentifiable statistical information may be used from your file for reporting purposes. The personal notes of the counsellor and the counsellee’s files are the sole property of Karis Counselling Services.

There are some limitations to professional confidentiality. If your counsellor receives a court order to release information found in your file, if a child under the age of 16 may be in need of protection, or in cases of any threat of harm to yourself or others, your counsellor is required to contact the appropriate authorities with the necessary information.

Those at Karis Counselling Services regularly participate in supervision or peer consultation. Some content (not identifying information) of your session may be divulged in an individual or group/peer supervisory setting.

Your sessions are recorded in the following manner: Notes


Please complete the form below and click the Submit button to send in your contract.

Name:

Preferred Email Address

Payment Type:
These services will be provided to you Pro-Bono, without charge.

I have read and understand the above counselling contract. Questions and clarifications have been adequately explained. I am in agreement to fully participate in the counselling relationship.

Signed on: (please enter date)

Signature of Counsellee #1 (please type your Full Name which will take the place of a signature):

Signature of Counsellee #2 (please type your Full Name which will take the place of a signature):