Free Counselling Contract Template
Counselling Contract
Introduction
This Counselling Contract ("Contract") is entered into between [Your Name], hereinafter referred to as the "Counselor," and [Client's Name], hereinafter referred to as the "Client," effective as of the date of signatures set forth below.
Client Information:
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Name: [Client's Full Name]
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Date of Birth: [Client's Date of Birth]
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Address: [Client's Address]
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Phone Number: [Client's Phone Number]
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Email Address: [Client's Email Address]
Counselor Information:
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Name: [Your Name]
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Professional License Number (if applicable): [License Number]
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Practice Address: [Your Company Address]
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Phone Number: [Your Company Number]
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Email Address: [Your Company Email]
Agreement:
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Nature of Services: The Counselor agrees to provide the Client with individual therapy services, consisting of one-on-one counseling sessions, aimed at addressing the Client's mental health and well-being concerns.
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Confidentiality: The Counselor agrees to maintain strict confidentiality regarding all information disclosed by the Client during therapy sessions, except as required by law or in cases where the Client poses a threat to themselves or others.
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Session Fees: The Client agrees to pay the Counselor the agreed-upon fee for each therapy session, payable [weekly/monthly/etc.]. The fee for each session is [Amount].
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Cancellation Policy: The Client agrees to provide at least [number] hours' notice in advance if they need to cancel or reschedule a therapy session. Failure to provide timely notice may result in the Client being charged for the session.
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Goals of Therapy: The Counselor and Client agree to work collaboratively towards achieving mutually agreed-upon therapy goals, as outlined during the initial assessment session.
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Duration of Sessions: Therapy sessions will typically last for [duration] minutes unless otherwise agreed upon by both parties.
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Termination of Services: Either party may terminate this Contract with written notice to the other party. The Counselor reserves the right to terminate services if, in their professional judgment, continued therapy is not beneficial to the Client.
By signing below, the parties acknowledge that they have read, understood, and agree to the terms and conditions outlined in this Counselling Contract.
Name: [Your Name]
Title: [Title]
Date: [DATE]
Name: [Client's Name]
Date: [DATE]
