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Counseling Services Client Consent Form


  1. Individual counseling is a confidential process designed to help you address your concerns, come to a greater understanding of yourself, and learn effective personal and interpersonal coping strategies.
  2. Services provided by our staff for counseling and consultations are offered free of charge to all currently enrolled students.  A personal commitment is crucial to the success of counseling. Due to the limited number of staff, we kindly remind you that you are responsible for cautiously assessing your own needs and keeping all of your scheduled appointments.
  3. Counseling sessions are scheduled for a maximum of 50 minutes on a weekly basis. Because of the large number of students requesting counseling, the Counseling Services generally provides short-term therapy. If more than 8 individual sessions are needed, a thorough evaluation by your counselor is necessary.
  4. At your first appointment, you will see a counselor for an intake interview. If individual counseling is recommended, you will be assigned to one of our staff counselors after your intake.
  5. If you need to cancel, do so as far in advance, at least 24 hours prior, as possible. You may call, email, or visit us to reschedule or cancel your appointment. If you miss an appointment, your counselor would contact you via phone call, email, or text message. Failing to reply will be counted as a no-show, and an accumulation of 2 no-shows and/or cancellation will accordingly lead to the termination of your counseling service.
  6. All interactions with Counseling Services, including scheduling of or attendance at appointments, content of your sessions, progress in counseling, and your records are confidential.
    • If there is evidence of clear and imminent danger of harm to self and/or others, a counselor is legally required to report this information to the authorities responsible for ensuring safety.
    • If, during the conversation in the counseling, you are legally involved in the cases of Mental Health Act, Domestic Violence Prevention Act, Sexual Assault Crime Prevention Act, Gender Equity Education Act, Child and Youth Sexual Exploitation Prevention Act, and The Protection of Children and Youths Welfare and Rights Act.
  7. You are entitled to terminate your counseling anytime. Please inform and discuss with your counselor in advance.


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