PASTORAL COUNSELING AGREEMENT In order to be fully informed about the pastoral counseling you  will be receiving, please read through the following agreement, sign, and date it. This form must be  completed and returned by the end of the first session. 

INFORMED CONSENT As a pastoral counselor I endeavor to create safe, non-anxious, & non-judgmental  spaces, as I co-journey with persons struggling with spiritual, emotional, social & psychological dilemmas  within their life’s journey, with the ultimate hope of their experiencing holistic healing & growth.  

CONFIDENTIALITY As a pastoral counselor I will adhere to commonly accepted codes of privacy and  confidentiality in counseling ethics. There are situations, however, in which the law requires that certain  information can be revealed without your consent. Under the discretion of the pastoral counselor, if  there is any indication that you may be a danger to yourself or others, or are involved in the abusing of a  minor, your information may be disclosed to appropriate mental health services or law enforcement.  Also, an issue may occasionally arise that would benefit involvement of another pastor. If deemed  appropriate, I may decide that a pastor be consulted to ensure the quality of care you are receiving. 

WAIVER OF LIABILITY In consideration for receiving pastoral counseling and guidance the person  receiving counseling agrees to release and waive any and all claims of any kind against Holistic Wellness  Oasis, its employees, or its members arising from or relating to participation in pastoral counseling.

By signing below, you are acknowledging that you understand and accept the guidelines stated above.