• Counseling Confidentiality Form

  •  - -
  • Confidentiality Agreement

    Purpose of Counseling:

    The purpose of counseling is to provide support, guidance, and a confidential space for discussing personal matters.

    Scope of Confidentiality:

    All information shared during counseling sessions, including discussions, records, and any written materials, is considered confidential.

    Exceptions to Confidentiality:

    Confidentiality may be breached if there is a risk of harm to oneself or others, or if required by law.

    Client Agreement:

    I, {name}, acknowledge and agree to the following:

    • I understand that all information shared in counseling sessions is confidential.
    • I recognize the exceptions to confidentiality as outlined above.
    • I will not disclose any confidential information shared by the counselor outside of counseling sessions.

    Counselor Responsibilities:

    The counselor will:

    • Ensure a safe and confidential environment for counseling sessions.
    • Discuss and reinforce the importance of confidentiality during sessions.
    • Take appropriate action if confidentiality is breached.

    Duration of Agreement:

    This confidentiality agreement is effective for the duration of my counseling sessions.

  •  - -
  • Clear
  • Should be Empty: