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Agape Bible Church
Counseling Consent Form
Our Goal: The purpose of biblical counseling is to help you meet the challenges of life in
a way that will please and honor the Lord Jesus Christ. We offer
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How to fill out counseling consent form
How to Fill Out a Counseling Consent Form:
01
Read the form carefully: Begin by carefully reading through the counseling consent form. Take note of any instructions, fields to be filled out, or any additional information provided.
02
Personal information: Start by filling out your personal information accurately. This may include your full name, address, contact numbers, date of birth, and email address.
03
Emergency contact information: Provide the contact details of a trusted person who can be reached in case of an emergency. This is crucial for the counselor to have someone to contact if the need arises.
04
Briefly state the reason for seeking counseling: In a designated section, briefly explain why you are seeking counseling services. This can help the counselor understand your concerns and provide appropriate support.
05
Consent to counseling services: Review the provided consent statement, which outlines the purpose, limits, and boundaries of counseling. If you agree to these terms, sign and date the consent form.
06
Confidentiality agreement: Understand and acknowledge the confidentiality agreement outlined in the form. This ensures that any information shared with the counselor will be kept confidential unless certain legal exceptions apply.
07
Release of information: If you wish to authorize the counselor to communicate or share information with specific individuals or organizations, provide their details and indicate the nature and extent of the information to be shared.
08
Consent for treatment: Grant consent for the counselor to provide the appropriate treatment for your specific needs. This may involve individual counseling, group therapy, or other forms of treatment discussed with the counselor.
Who Needs a Counseling Consent Form?
01
Individuals seeking counseling services: Anyone seeking professional counseling services may be required to fill out a counseling consent form. This ensures that both the counselor and the individual seeking help have a clear understanding and agreement on the terms and conditions of the counseling process.
02
Minors: For individuals who are minors (under 18 years old), parental consent is typically required. Parents or legal guardians are usually asked to fill out the counseling consent form on behalf of the minor.
03
Third-party involvement: In some cases, when a third party, such as an employer, insurance company, or legal representative, is involved in the counseling process, they may be required to fill out a counseling consent form.
Note: The specific requirements for who needs to fill out a counseling consent form may vary depending on the counselor, therapy center, or jurisdiction. It is advisable to check with the specific counseling service provider for their policies and procedures.
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