Please tell us about your concerns in detail. (Describe what made you seek
therapy)
By proceeding with therapy sessions with our Center, you agree to the
following terms and conditions:
1. Confidentiality: All information shared during therapy sessions will be kept
strictly confidential and will not be disclosed to any third party without your
written consent, except in cases where there is a risk of harm to yourself or
others or where required by law. I, as a mental health professional, am bound by
the laws of confidentiality and will take all necessary measures to protect your
privacy.
2. Limits of confidentiality: Please note that while all information shared during
your therapy sessions will be kept confidential, there are certain limits to
confidentiality that I am required to adhere to by law. These include, but are not
limited to, reporting child/elder abuse, cases where there is a risk of harm to self
or others, or a court order for releasing information.
3. Professional conduct: I will conduct therapy sessions in a professional and
ethical manner, adhering to the code of ethics set by my profession. I will not
engage in any behavior or actions that may harm you physically, emotionally, or
psychologically. If at any point, you feel uncomfortable or believe that I am acting
unethically, please inform me immediately.
4. Non-discrimination: Our Center does not discriminate based on race,
ethnicity, religion, gender, sexual orientation, age, or disability. We believe in
providing equal access and treatment to all individuals seeking therapy.
5. Risks and benefits: Therapy can be a transformative and healing experience;
however, it may also bring up uncomfortable feelings and emotions. It is
important to understand that therapy is not a quick fix and requires time, effort,
and commitment. There is no guarantee of a specific outcome, and results may
vary for each individual.
6. Emergencies: In case of an emergency, please contact your local emergency
services or go to the nearest emergency room. I may be available for phone
consultation during regular business hours, but I cannot guarantee immediate
availability.
7. Termination of therapy: I reserve the right to terminate therapy if I believe it is
no longer beneficial or appropriate for you. I will provide you with referrals to other
mental health professionals or resources, if needed.
By ticking below, you acknowledge that you have read and understood the above
terms and conditions and agree to adhere to them during your therapy sessions
with our Center. You also understand that this disclaimer does not
constitute a contract and may be subject to change at any time. Please do not
hesitate to ask any questions or seek clarification before signing.