FIRST MISSIONARY BAPTIST CHURCH
COUNSELING MINISTRY
PERSONAL DATA INTAKE FORM
Purpose Statement:
The focus of First Missionary Baptist Church Counseling Ministry is to provide a safe, caring, and supportive environment to discover Christ answers to personal struggles and relational challenges. Our counselors have been called into the ministry of biblical counseling and guidance. Our counselors have gone through extensive professional and/or biblically based counseling training for the purpose of serving God and the community. The goal of church counseling is to bring God's truth, hope and healing to whatever situation or circumstances the counselee have or currently experiencing.
Qualifications of counselors:
The counselors do not necessarily possess professional licenses or certifications issued by the State of North Carolina. No counselor of First Missionary Baptist Church will render any legal opinion or medical advice.
Our Approach:
First Missionary Baptist Church Counseling Ministry employs methods of biblical counseling and guidance utilizing spiritual/biblical principles. The Holy Spirit, not the counselor, is the agent of change. Our goal is to present God's plan for victory during one's circumstances.
Limitations of Confidentiality:
It is understood (and agreed) that all statements, whether written or verbal, are of a confidential nature and will not be disclosed without written consent. The following exceptions will result in confidentiality being waived:
1. FMBC reserve the right to report child abuse or suspicion of child abuse of any type to the proper authorities and/or the right to cause a report of child abuse to occur.
2. FMBC reserve the right to disclose to the appropriate person, agency, or civil authorities any harm that a person may attempt or desire to do to oneself or to others.
3. FMBC reserve the right to consult with other professionals regarding your sessions upon written consent.
Resolution of Disagreements:
If a dispute arises between the person receiving counseling and the counselor regarding the counseling session, one should bring this dispute to the attention of the Christian Counseling Ministry Servant-Leader and/or the Senior Pastor of the church.
Waiver of Liability:
In consideration for receiving biblical counseling and guidance from First Missionary Baptist Church Counseling Ministry, the counselee agrees to release and waive all claims of any kind against the counselor or the church, which may be related to their counselor or conduct.
Session Length:
Counselees are provided up to FOUR (4) FREE Pastoral Counseling sessions. * (This does not apply to pre-martial counseling). A session is a maximum of 55 minutes, which consists of 50 minutes in session and 5 minutes closing and prayer. If the issues presented indicate a need for intensive clinical counseling, in accordance with church policy, appropriate referrals will be made to a fee-based Christian Mental Health Professional.
Fees:
Members of First Missionary Baptist Church and non-members of the community do not pay for the services of biblical counseling/guidance. * (There is a fee for pre-martial counseling).
Late Policy:
Counselees more than 15 minutes late to their scheduled appointment will be asked to re-schedule. It is to the counselee’s advantage to be timely to receive the full benefit of the scheduled appointment.
Cancellations or Reschedules:
In the event the counselee needs to reschedule or cancel an appointment we ask that you call at least 24 hours in advance. This allows us to reschedule others who are waiting for an appointment. As a courtesy to the counselee, the counselor may call within 24 hours of the appointment, reminding the counselee of their appointment. The call will be made to the number given by the counselee. The counselor will not leave a message concerning the nature of the call on voicemail or to anyone other than the said counselee.
Referrals:
When issues arise beyond the counselor scope of expertise, a referral is suggested. In suggesting a referral to outside agencies, First Missionary Baptist Church Counseling Ministry assist with identifying providers. The counselee takes full responsibility for seeking out the proper provider. Therefore, it is incumbent upon the counselee to seek out the desired “fit” regarding Professional Christian Counsel.