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 Helping Hand Counseling Center: 2 - Client Consent To Treatment Form By filling out and clicking send on the Helping Hand Counseling Center - Client Consent to Treament Form, you indicate that you understand and agree to the terms and conditions stated below: 
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Thank you for contacting Helping Hand Counseling Center! - You understand that your counselor is licensed and practices in the State of Florida, and is governed by those laws in the State of Florida.
- You agree that you are at least 18 years old.
- Helping Hand Counseling Center is not equipped for crisis or emergency situations. Helping Hand Counseling Center will not provide emergency care services of any kind. If you are in crisis or have an emergency please dial 911.
- You agree to supply your true full name, address, phone number and e-mail address on the Helping Hand Counseling Center Client Response Form. You agree that all of the information you have provided in the Client Response Form is accurate, and that no important information has been deliberately omitted. You understand that if any of this information is inaccurate, this may be a major limitation in our ability to help you.
- While we are hopeful that your work together with Helping Hand Counseling Center will be helpful to you, Helping Hand Counseling Center cannot guarantee a positive outcome.
- Helping Hand Counseling Center reserves the right to choose whether or not to work with you. If, during your work together, your counselor discovers that you are not, in fact, someone who can benefit from therapy, your counselor will discuss this with you immediately and will suggest that you seek out the services of another therapist.
- If you are currently taking medication for depression, anxiety, or any psychological or psychiatric problem, Helping Hand Counseling Center may ask for your permission to contact your physician/s.
- Confidentiality In General: Helping Hand Counseling Center protects the confidentiality of the communications and contacts with all clients. Helping Hand Counseling Center will only release information about your work to others with your written permission, or if Helping Hand Counseling Center is required to do so by a court order or legal subpoena.
- Confidentiality Exceptions: According Florida law there are three situations where Helping Hand Counseling Center is required to break the confidentiality that Helping Hand Counseling Center works so hard to retain, and call local law enforcement or social authorities.
- 1. If, during your sessions you give any information that would lead Helping Hand Counseling Center to believe that you may hurt yourself, someone else, or someone may hurt you in any way, Helping Hand Counseling Center will notify the appropriate authorities.
- 2. If during your sessions you give any information that would lead Helping Hand Counseling Center to believe that there is neglect or abuse of a minor, Helping Hand Counseling Center will notify the appropriate authorities.
3. If during your sessions you give any information that would lead Helping Hand Counseling Center to believe that a regulated health professional has been involved with sexual abuse, Helping Hand Counseling Center will notify the appropriate authorities.
HELPING HAND COUNSELING CENTER DOES NOT PROVIDE COUNSELING OR THERAPY FOR ISSUES RELATED TO PEDOPHILIA (INCLUDING INTERNET)
- Helping Hand Counseling Center will do everything possible to protect your identity and keep all confidences. However it is, at times, not possible to guarantee 100% protection of the confidentiality of phone calls if you choose to use a cordless or cell phone during a phone session. At times it is possible for someone with a scanner to possibly hear the conversation. The goal of phone counseling is to help you. If at any time, you or Helping Hand Counseling Center feel that working together is not helpful enough to you, either is free to terminate the relationship.
- There are no other explicit or implicit commitments to the therapeutic relationship.
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