Counseling for a Better Life, PLLC: Confidentiality Form

Supportive Talk by Phone from Minneapolis, MN

Supportive Talk conversations are confidential. This means that the conversations held in sessions are private. The counselor will not disclose the details of these discussions. By law, counselors are mandated reporters. This means there are some exceptions to confidentiality. The client can always chose what they want to disclose. Please be aware of the limits to confidentiality so you can chose what you want your counselor to know. Here is the main list of the limits to confidentiality. These basically include client consent forms, medical emergencies, if a client reports a child, elder or mentally impaired person is in danger of being harmed, court-ordered disclosures, a duty to warn or help if client states they plan to harm themselves, client states that another person is in danger of seriously being harmed in the future, medical emergencies, (i.e.: a 911 situation) and natural disasters that interfere with private records. In these instances, it is the obligation of the counselor to follow legal procedures or take precautions to ensure the safety of all. Please sign below to acknowledge that you have read and understand the policy of confidentiality and its exceptions.

* Required

Last Name *

Your answer

First Name *

Your answer

Phone Number *

Your answer

E-mail *

Your answer

Submit

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service