Confidentiality form

Confidentiality

The services we offer are confidential unless you give us consent in writing to communicate with someone on your behalf. There are some exceptional circumstances when we cannot maintain strict confidentiality because of ethical or legal requirements. The circumstances include:

• When the clinical records are subpoenaed by court

• When child abuse or neglect is suspected

• In order to prevent harm to yourself or someone else

Child Therapy Services

The service we provide is intended to address your presenting needs. You and your counselor, coach or facilitator will discuss your situation, establish goals, and the number of sessions anticipated. If the services of another professional are required, we will make every effort to assist you and arrange a referral.

Cancellation of Appointments

We ask that you provide at least 24 hours' notice if you are unable to keep an appointment. You will be charged for a missed appointment where no notice was given.