It is for freedom that Christ has set us free

Garden City Counseling offers a supportive and nurturing environment tailored for individuals seeking personal growth and healing. We are dedicated to helping clients navigate life's challenges, enhance their well-being, achieve their goals, and grow in their relationship with Jesus. With a range of services including individual counseling, couples counseling, and holistic coaching, we empower clients through evidence-based practices and compassionate guidance. At Garden City Counseling, your journey towards a more integrated life begins with understanding, acceptance, and proactive change.

RELEASE OF LIABILITY FORM

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This RELEASE and Waiver of LIABILITY is made and entered into on this date by and between Garden City Counseling and name as stated above (counselee). *

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Release

As a precondition to any and all counseling/mentoring services to be provided by the counselor, the undersigned, in consideration of the services provided by the counselor, both parties acknowledging the adequacy of said consideration, does hereby remise and release from any and all injuries, losses, damages, liabilities, defenses, claims, actions, causes of action, suits, debts, promises, demands, or agreements, of whatever nature or kind, known or unknown, whether based in law or in equity, that either party hereto ever had or now has or that any one claiming through or under either party may have or claim to have, which was raised or asserted or could have been raised or asserted against the other party at any time prior to the execution of this agreement, including, but not limited to, any and all claims arising out of, by reason of, or in any way related to the subject matter of the mentoring relationship/services as a direct or indirect result of any involvement Mentee may have with the mentor or the mentors church or any other partnering/hosting church. *

I Agree

Confidentiality

Confidentiality is an important aspect of the spiritual friendship relationship, and we will carefully guard the information you entrust to us. All communications between you and our counselor will be held in strict confidence, unless you (or a parent in the case of a minor) give authorization to release this information. The exceptions to this would be: 1.) if a person expresses intent to harm himself/herself or someone else; 2.) if there is evidence or reasonable suspicion of abuse against a minor child, elder person, or dependent adult; 3.) if a subpoena or other court order is received directing the disclosure of information; 4.) if/when mentors consult with their supervision; or 5.) if a person persistently refuses to renounce a particular sin (habitual unrepentant rebellion against the Word of God) and it becomes necessary to seek the assistance of either terminating the mentoring or bring in others in the church or their family to encourage repentance, restoration, and reconciliation (Matthew 18:15-20). Please be assured that our mentors strongly prefer not to disclose personal information to others, and they will make every effort to help you find ways to resolve a problem as privately as possible. *

I Agree

Pastoral Release

Counselor may consult pastoral and counseling team when appropriate.

I Agree

I HAVE READ AND UNDERSTAND ALL OF THE ABOVE: Digital Signature

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***Parent/Guardian if counselee is under 18 years of age: Digital Signature

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It is for freedom that Christ has set us free

RELEASE OF LIABILITY FORM

CLIENT INTAKE FORM

You belong here. ♡