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Main Street Counseling Center Sheri Golly, LCSW Informed Consent, Office/Financial Policy, HIPAA and Release of Liability Counseling is a confidential process designed to help you and/or your child

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How to fill out counseling informed consent form

01

Begin by reading the counseling informed consent form carefully.

02

Fill in your personal information such as your name, address, and contact details.

03

Provide your emergency contact information in case of any unforeseen circumstances.

04

Understand the purpose and nature of the counseling sessions or program.

05

Indicate your agreement to participate in the counseling program by signing and dating the form.

06

If there are any risks or potential benefits associated with the counseling, make sure to acknowledge them.

07

Be honest and accurate while providing your medical history or any other relevant information.

08

If there are any fees or costs involved, ensure that you are aware and agree to them.

09

Clarify the terms of confidentiality and the limits to it.

10

If you have any questions or concerns, don't hesitate to ask the counselor before signing the form.

Who needs counseling informed consent form?

01

Individuals seeking counseling services or therapy sessions need to fill out the counseling informed consent form.

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What is counseling informed consent form?

The counseling informed consent form is a document that outlines the details of therapy sessions, including the expectations, responsibilities, and rights of both the client and the counselor.

Who is required to file counseling informed consent form?

Both the client and the counselor are required to sign and file the counseling informed consent form before beginning the therapy sessions.

How to fill out counseling informed consent form?

To fill out the counseling informed consent form, both the client and the counselor must read and understand the contents of the form, then sign and date it to acknowledge their agreement.

What is the purpose of counseling informed consent form?

The purpose of the counseling informed consent form is to establish clear communication and understanding between the client and the counselor, ensuring that both parties are aware of their roles and responsibilities during the therapy sessions.

What information must be reported on counseling informed consent form?

The counseling informed consent form must include details about the counselor's qualifications, therapy goals, confidentiality policies, session fees, and emergency contact information.

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