Christian Counselors provides quality counseling services that are distinctively Christian in orientation. We believe that upon beginning to work with us, you will experience the benefits of our commitment to excellence.

Successful counseling relationships are built on clear expectations. Here are the principles, policies, and procedures that will impact our journey together. Questions can readily be discussed during the Orientation and Assessment session or with your counselors at any time.

Be assured that a certain amount of anxiety before and during early sessions is normal. You should also expect that you may feel worse before you begin to feel better. The process of counseling will involve speaking about experiences that are very difficult to face. Although few people find the process pleasurable, most people find counseling helpful and ultimately very rewarding.

Many people have pre-formed ideas about what a Christian Counselor would want them to talk about or how they "should be" during a session. Please be assured that you are not on stage. Honesty about your thoughts and feelings is the most important contribution you can make to the process. Your counselor will provide you with attention and respect along with expertise in an effort to help you resolve the difficulties that brought you to Christian Counselors. Our goal is to help you enjoy the fullness of all you were made to be.

Counselors and clients will jointly clarify goals, methods and approaches. Our assessment procedures are designed to be thorough a nd to enable you to express your story, struggles and desires. Clients are free to accept the counseling plan that your counselor offers or may ask to explore alternative strategies. It is acceptable to request a referral to another counselor  when additional expertise or another perspective is desired.

A unique distinctive of Christian Counselors is that our staff are competent and prepared to blend resources from the Christian faith into our counseling plans when this is the expressed desire of our clients. You will set the expectations and the preferences for your counseling care.

We are committed to keeping your information confidential. The law, professional ethics, and common sense prohibit anything you say or do from being shared with anyone else without your written permission. These are the exceptions that you should know about:

• If you are      referred by the court or a legal agency, we may be required to furnish      information to them.
• If you are      involved in certain kinds of litigation and inform the court of services      you have received from us, you may be waiving your right to have your      records remain confidential.
• If you reveal a      threat to harm yourself or someone else, we are obligated to inform      helpers or those at risk.
• If there is      reason to suspect child abuse or neglect, we are obligated to report this to      a state agency.
• If there is      reason to suspect elder abuse or neglect, we may be required to report      this to a state agency.
• If you are a      minor, your parents or guardians will be informed of your progress in      treatment.

HIPAA Privacy Regulations have been established by the U.S. Department of Health and Human Services to establish a minimum level of privacy protection for health care information. The Privacy Rule establishes a patient's rights regarding the use and disclosure of his/her health care information. Each medical/mental health practice that collects health care information must take steps to control access to this patient data as well as to inform patients of their privacy rights. Christian Counselors handles your health information in ways that are consistent with these regulations.

Our explicit policies to protect the privacy of your personal health information are as follows:

• Christian      Counselors shares your health information only with those employees with      whom it is necessary to perform the services you have requested.
• Counselors do      consult on occasion with one another for peer and professional supervision      to insure quality service. All Christian Counselors employees agree to      follow privacy and confidentiality guidelines.
• Personal      information is stored in a secure space or computer.
• Health      information is generally retained for a minimum of seven years, after      which it is shredded, erased or destroyed.
• Christian Counselors      will routinely evaluate our communication and recording procedures to      maintain our commitment to your confidentiality and privacy.

Protecting your privacy is important. If you have any questions or concerns regarding privacy, please ask during the orientation and assessment session or speak with your counselor.

By proceeding, you indicate that you understand how Christian Counselors abides by HIPAA confidentiality and privacy guidelines.

Christian Counselors is not equipped to supervise children. Please do not leave your children unattended in the waiting room.

• Appointments are      about one hour, scheduled in advance, and on a weekly basis.
• Scheduling an      appointment represents your counselor's commitment to reserve time for      you. Any cancellations must be made at least 24 hours in advance or you      will be charged for the time.
• You will be billed for late cancellations or missed appointments;      this charge will be the responsibility of the client.

By proceeding, you indicate that you understand that you are directly responsible for the full session fee for any missed appointments unless you call to cancel/reschedule at least 24 hours before your scheduled appointment.

Various types of electronic communications are common in our society. Many individuals believe this is the preferred method of communication, whether their relationships are social or professional. Many of these modes of communication put privacy at risk. Therefore this can be inconsistent with the law and with the standards of the mental health profession. These policies are posted to assure the security and confidentiality of your consultation as well as to assure that it is consistent with ethics and the law.

• Digital      communication is only done with your permission and is only available for      administrative purposes while clients are getting started at Christian Counselors.      Email exchanges should be limited to submitting forms.
• Do not email any      Christian Counselors clinician about treatment matters. Email is not a      secure way to contact a counselor. Telephone or face-to-face contact is a      more secure mode of communication.
• Christian Counselors     advisers will not communicate or contact any clients through social media      platforms. If a Christian Counselors staff member discovers that an online      relationship has accidentally been established, they will cancel that      relationship. These casual social contacts can create significant security      risks.
• If you have an      online presence, there is a possibility that you may encounter a Christian      Counselors adviser by accident. If that occurs, discuss this with your      counselor. Communication with clients online does have a high potential to      compromise the professional relationship. Please do not try to contact a      Christian Counselors adviser in this manner.
• Web searches are      not utilized to gather information about clients without your permission.      Christian Counselors contends that this violates your privacy rights. Christian      Counselors understands that you might choose to gather information about      our agency or advisers in this way. If you encounter any information      about us through web searches, or in any other fashion, please discuss      this with your counselors  during      session so that any potential impact on your treatment can be addressed.
• There are web      outlets for clients to review their health care provider on various sites.      Unfortunately, mental health professionals cannot respond to such comments      and related errors because of confidentiality restrictions. Please do not      rate a clinician while you are in treatment together on these websites.      This is because it has potential to damage the therapeutic relationship.
• Therapy is      intense interpersonal communication. There is significant benefit to      working through disagreements or misunderstandings with advisers      directly. This is a superior way to constructively address concerns and      thus is preferable to blogging or posting web comments.
• Some Christian Counselors      advisers may be willing to utilize text messaging with your permission      for scheduling purposes only. Please do not send your counselors  a text message unless explicit      arrangements have been made.

By proceeding, you consent to the use of texting to schedule appointments with your counselor.

• An explanation of      our usual and customary fees is available in advance from Christian Counselors.
• The Initial      Consultation is offered at a reduced rate of seventy-five dollars ($75).      We strongly recommend this optional service in      order to provide you with the best care here at Christian Counselors.
• The usual and      customary charge for the second visit (Orientation & Assessment      session), is one hundred fifty dollars ($150).
• Counseling      sessions are one hundred fifty dollars ($150) to counselors. It is most      helpful if the handling of funds occurs at the onset of each session.      Payments and co-payments are due at the time of service.
• A thirty-five      dollar ($35) charge will be assessed for any returned checks.

By proceeding you indicate that you understand that, should you choose to utilize the Initial Consultation service,  you agree to pay the $75.00 and all future fees out-of-pocket.

By proceeding you indicate that you understand that payment is due at the beginning of each session unless other arrangements are made.

By proceeding you indicate that you understand that you are responsible to pay the full session fee at the time of service. 

• We do not offer      crisis intervention services. In the event of a life-threatening      emergency, we recommend you go to an Emergency Room or call 911.
• If you have an      urgent matter that you need to discuss with your counselor between      scheduled sessions, you may do so by phone counseling. Please clearly indicate to the answering service that      the matter is urgent.
• For current      patients, the fee for phone counseling will be assessed at twenty-five      dollars ($25) per each 15-minute increment. Payment for this service      should be made at the time of the next scheduled session.

By proceeding, you indicate that you have read and understood the information regarding fees, and crisis services.

• My choice is      voluntary and I understand I may terminate counseling at any time.
• I understand that      there is no assurance that I will feel better. Christian Counseling is a      cooperative effort. I will work with my counselors in a cooperative manner      to resolve my difficulties.
• I understand that      I can revoke my consent at any time except to the extent that counseling      has already been rendered or that action has been taken in reliance on      this consent, and that if I do not revoke this consent, it will expire      automatically one year after all claims for counseling have been paid.

I authorize payment to be made to Christian Counselors.

Signed:_______________________  _______________________ Date_____________