OCD Consulting Disclosure Agreement
This contract is to ensure you’re informed about your rights as a consultation or coaching client.
By clicking the box below, you’re acknowledging that you’ve reviewed, comprehended, and consented to this disclosure.
Client Rights and Vital Information:
- The information shared during our coaching and/or peer support consultations is confidential. Your information won’t be revealed without your consent unless required by law.
- You have the right to receive details from me, Jonathan, about my support methods, the techniques I employ, the potential duration of our peer relationship (if determined), and our fee structure. My approach is collaborative, person-centered, and strength-based, infused with the principles of Motivational Interviewing.
- I will break confidentiality if there is suspected abuse of someone with special needs, child abuse, or elder abuse, or if you tell me you are going to hurt yourself or others.
- You’re in control of when our peer relationship ends; you can terminate it at any time.
Fee Information: My standard fee for a 50-minute individual peer support consultation or coaching session is $75. To secure your one-on-one session, I request credit card payment at the time of booking. A non-refundable full payment is required to confirm your appointment. Please note that the holding fee cannot be refunded or transferred in case of cancellations, no-shows, or rescheduling within 24 hours of the appointment.
Prior to the appointment, clients must acknowledge this disclosure agreement. I won’t meet with any client who hasn’t acknowledged it. If you don’t respond within 15 minutes past the scheduled appointment time, it will be considered a no-show. In such cases, the holding fee won’t be refunded or transferred to a rescheduled appointment. Please be aware that we do not accept insurance for our services.
If you decide to have an ongoing coaching or peer support relationship, I do offer long-term contracts. We can discuss these options when we meet.
Scheduling and Emergency: I’m generally available for scheduling on weekdays, excluding Saturday to Monday. If an emergency occurs outside these hours, please dial 911 or visit the nearest emergency room. Sometimes, as peer specialists, I may need to consult with colleagues or outside council regarding issues raised in our sessions, but your confidentiality remains protected during these consultations per the guidelines above.
Non-Emergency Support: My role as a peer specialist and coach involves providing non-emergency support services by appointment. If I believe your therapeutic issues are beyond my competence or outside my scope of practice, I may choose to refer, terminate, or consult. Please note that I do not offer crisis intervention. If you’re experiencing thoughts of self-harm or suicidal ideation, please seek immediate help from the nearest emergency room, a mental health crisis center, or call 911.
Emergency Contact: If, for any reason, you’re unable to reach me via email or the provided phone number and you’re facing a genuine emergency, you agree to call 911 or check yourself into the nearest hospital emergency room. In the case of an after-hours, non-life-threatening clinical emergency, you may email me, and I will respond during regular business hours. Please understand that I do not provide after-hours service without an appointment.
About Peer Support and Coaching: Peer support and coaching is a voluntary, supplementary service for mental health treatment. I am not a licensed therapist and do not provide clinical advice or therapeutic suggestions. My role is to support and normalize your experiences with mental illness based on my own lived experiences. I will share my story and the lessons I have learned, be with you along your journey, and provide resources. By acknowledging this, you understand that peer support does not replace clinical treatment for mental health diagnoses.
Acknowledgment: By checking the acknowledgment box, you’re confirming that you’ve read, understood, and agree to the disclosure statement for consultation and peer support services. Additionally, you agree to pay the specified amount for these services.