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  • 2nd Chance Counseling

    Counseling Services Consent
  • 2nd Chance Counseling Services: Most people enter into counseling to heal suffering, to increase well-being and to explore and ultimately understand and move through emotional and psychological obstacles in their lives. This is a mutual agreement negotiated between the Counselor and the Client prior to the commencement of counseling. It sets out the responsibilities of our Counselor towards his/her clients, and also the client's responsibilities in the counselling relationship. We value our relationship with our clients and believe that such relationship is the beacon in the healing process.  We believe that each individual is unique and has his own way of addressing resolutions. Thus, we believe in a wellness model that helps our clients empower themselves by focusing on what works for them and not in a systematic approach that provides a generic procedure on working on a treatment. One's journey is not the same as the other.

    Appointments: A counseling session is 50 minutes, and occur weekly at the same time and day for six weeks unless we have made arrangements for a longer or shorter session. Your scheduled appointments have secured your time in my calendar. I require a 24 hour notice if you need to cancel with the exception of an emergency. If you miss 2 consecutive sessions without contact, we will assume that you are no longer able to attend and withdraw your contract.

    Confidentiality: Both the laws and the standards of my profession require that I keep appropriate treatment records and that I safeguard your privacy. Information will be shared only with those persons you approve of with your signature on a "Consent to Release Confidential Information" form. The following circumstances are necessary exceptions:

    1) When there is a serious threat to my health and safety or the health and safety of you or another individual. I am legally obligated to contact the appropriate authorities including Child Protective Services for suspected abuse or neglect.

    2) No authorization is required when verbal permission is given to speak with family members who are directly involved with your treatment.

    Payment Agreement: My session fee is $50 per 50-minute session. Full payment by check or cash is due at the time of service unless prior arrangements are made. A 10% finance charge will be added on any unpaid balance each month. You will be also be responsible for a $25 charge to cover any checks returned for insufficients funds. No insurance payment accepted at this time.

    Contact Information: You may leave a voice message at (314) 357-9663 or email me at 2ndcgo@gmail.com. I make every effort to respond to you within 24 hours with the exception of weekends and holidays. If you are in a crisis and I am not available for an extended time, please call the Crisis Center near in your state. 

  • Client's Rights The client may ask questions on what to expect during and end result of the therapy. The client may decline to proceed the therapy as to the techniques which may be conducted by the therapist. The client may cease to continue therapy anytime, without any impediment and may return to therapy anytime. The therapist has the right to dismiss the client from the course of therapy. The client has the right to review his or her records from the therapist. Right to confidentiality: Within limits provided for by law, all records and information acquired by the therapist shall be kept strictly confidential in accordance to the principles of a doctor-patient relationship. All information will not be shared or revealed to any person, agency, or organization without the prior written consent of the client. The client can raise any concerns and to speak with the therapist immediately of any concerns provided that the therapist is likewise available to discuss matters with the client.

  • 2nd Chance Counseling Services: Most people enter into counseling to heal suffering, to increase well-being and to explore and ultimately understand and move through emotional and psychological obstacles in their lives. This is a mutual agreement negotiated between the Counselor and the Client prior to the commencement of counseling. It sets out the responsibilities of our Counselor towards his/her clients, and also the client's responsibilities in the counselling relationship. We value our relationship with our clients and believe that such relationship is the beacon in the healing process.  We believe that each individual is unique and has his own way of addressing resolutions. Thus, we believe in a wellness model that helps our clients empower themselves by focusing on what works for them and not in a systematic approach that provides a generic procedure on working on a treatment. One's journey is not the same as the other.

    Appointments: A counseling session is 50 minutes, and occur weekly at the same time and day for six weeks unless we have made arrangements for a longer or shorter session. Your scheduled appointments have secured your time in my calendar. I require a 24 hour notice if you need to cancel with the exception of an emergency. If you miss 2 consecutive sessions without contact, we will assume that you are no longer able to attend and withdraw your contract.

    Confidentiality: Both the laws and the standards of my profession require that I keep appropriate treatment records and that I safeguard your privacy. Information will be shared only with those persons you approve of with your signature on a "Consent to Release Confidential Information" form. The following circumstances are necessary exceptions:

    1) When there is a serious threat to my health and safety or the health and safety of you or another individual. I am legally obligated to contact the appropriate authorities including Child Protective Services for suspected abuse or neglect.

    2) No authorization is required when verbal permission is given to speak with family members who are directly involved with your treatment.

    Payment Agreement: My session fee is $50 per 50-minute session. Full payment by check or cash is due at the time of service unless prior arrangements are made. A 10% finance charge will be added on any unpaid balance each month. You will be also be responsible for a $25 charge to cover any checks returned for insufficients funds. No insurance payment accepted at this time.

    Contact Information: You may leave a voice message at (314) 357-9663 or email me at 2ndcgo@gmail.com. I make every effort to respond to you within 24 hours with the exception of weekends and holidays. If you are in a crisis and I am not available for an extended time, please call the Crisis Center near in your state. 

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