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Our Services

NEW PATIENT PAPERWORK

The following paperwork must be filled out and submitted 24 hours before the initial counseling session.

EXPLANATION OF SERVICES

This document explains what you can expect from counseling, including topics such as confidentiality, client-counselor interactions, billing, and more. 

CONFIDENTIALITY & INFORMED CONSENT

By signing this document, you are consenting to services with Nine Lives Counseling Service, as well as indicating you understand your privacy rights when you engage in services.

Sign Electronic Consent Form

CONSENT TO TELEBEHAVIORAL

By signing this document, you are consenting to services with Nine Lives Counseling Service, as well as indicating you understand your privacy rights when you engage in services.

SUICIDE & HOMICIDE DISCLOSURE AGREEMENT

This document outlines the process of what happens if a client discloses an imminent risk of suicide or homicide, and the steps the counselor will take to ensure the safety of the client and others.  This document must be signed by the client so that they understand their rights during such disclosures, as well as legal/ethical obligations of the counselor.

BILLING POLICIES

This document outlines billing policies, as well as procedures for the client to pay outstanding invoices.

If you would like these documents in a language other than English for your own files, please email ninelivescounseling@gmail.com .

Contact

+31 6 4866 8826

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