Church Counseling Service Contract Format
Church Counseling Service Contract Format
This Counseling Service Contract (the “Contract”) is made and entered into on this [Month Day, Year], by and between:
[Your Company Name]
Address: [Your Company Address]
Phone: [Your Company Number]
Email: [Your Company Email]
(hereinafter referred to as "Church")
and
[Client’s Name]
Address: [Client’s Address]
Phone: [Client’s Phone Number]
Email: [Client’s Email Address]
(hereinafter referred to as "Client")
1. Purpose
The purpose of this Contract is to formalize the agreement between the Church and the Client regarding the provision of professional counseling services. The Church aims to provide support and guidance to the Client in addressing and managing personal, relational, or family issues. These services are designed to foster personal growth, improve relationship dynamics, and enhance overall well-being through a structured therapeutic process.
2. Services Provided
The Church agrees to provide the following types of counseling services to the Client:
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Individual Counseling: One-on-one sessions focused on addressing the Client's personal emotional, psychological, or behavioral issues. These sessions aim to help the Client explore personal challenges, develop coping strategies, and achieve personal goals.
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Couples Counseling: Sessions designed to assist couples in enhancing their relationships, improving communication, and resolving conflicts. The goal is to help couples strengthen their partnership and address issues that may be affecting their relationship.
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Family Counseling: Counseling aimed at addressing and improving family dynamics. This may involve working with multiple family members to resolve conflicts, improve communication, and strengthen family relationships.
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Group Counseling (if applicable): Sessions involving multiple participants who share common concerns or goals. Group counseling provides a supportive environment where individuals can gain insights from others with similar experiences and learn from group interactions.
3. Session Details
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Frequency: Counseling sessions will be scheduled [Monthly] or at a frequency mutually agreed upon by both parties. The specific frequency and schedule will be determined during the initial consultation and can be adjusted based on the Client’s needs and progress.
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Duration: Each counseling session will last approximately [60 minutes/90 minutes], unless otherwise agreed upon. The duration may vary depending on the nature of the counseling and the progress made during each session.
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Location: Counseling sessions will be held at [Your Company Address] or conducted online via [Zoom] as mutually agreed upon. If sessions are conducted online, the Client will need access to a stable internet connection, a suitable device (e.g., computer, tablet, or smartphone), and a private, quiet space for the sessions.
4. Fees and Payment
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Fee: The fee for each counseling session is $[0]. This fee covers the time, expertise, and resources provided by the counselor during the session. The fee structure is designed to reflect the professional nature of the counseling services offered.
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Payment Terms: Payments are due [at the time of the session/within [0] days of the invoice date]. Accepted payment methods include [Online Payment]. Payments should be made to [Church Name] and can be processed through [Credit Card].
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Cancellation Policy: Cancellations made less than [24 hours] before the scheduled session will incur a charge of $[0], unless the cancellation is due to an emergency or unforeseen circumstances. The Client is encouraged to provide as much notice as possible if they need to cancel or reschedule a session.
5. Confidentiality
The Church is committed to upholding the highest standards of confidentiality regarding all information disclosed during counseling sessions. Confidentiality is crucial to creating a safe and trusting environment for the Client. The Church will comply with applicable state and federal privacy laws, including but not limited to [HIPAA or other relevant legislation]. Confidentiality may only be breached in the following circumstances:
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When disclosure is required by law, such as reporting abuse or neglect.
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When there is a risk of serious harm to the Client or others, which may require reporting to appropriate authorities or individuals.
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When the Client provides written consent for the disclosure of information.
6. Record Keeping
The Church will maintain detailed and secure records of all counseling sessions. These records will include session notes, treatment plans, and any other relevant documentation. Records will be kept for a period of [0] years in compliance with applicable regulations and best practices. The records will be stored in a secure location to ensure confidentiality and will be disposed of in a manner that protects the privacy of the Client, such as shredding or secure digital deletion.
7. Responsibilities of the Client
The Client agrees to the following responsibilities:
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Attendance: Attend scheduled counseling sessions punctually. If the Client is unable to attend a session, they must notify the Church as soon as possible to reschedule or cancel the appointment.
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Communication: Communicate openly and honestly with the counselor. Effective counseling relies on the Client’s willingness to share relevant information and participate fully in the therapeutic process.
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Engagement: Follow the counselor’s recommendations and actively engage in the therapeutic process. This includes completing any assignments or tasks suggested by the counselor and applying the strategies discussed during sessions.
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Respect: Respect the confidentiality and boundaries established by the counselor. This includes maintaining appropriate behavior during sessions and respecting the privacy of other participants in group counseling, if applicable.
8. Termination of Services
Either party may terminate this Contract by providing [Number] days’ written notice to the other party. Reasons for termination may include, but are not limited to, non-payment, failure to adhere to the agreed-upon terms, or a mutual decision that counseling is no longer necessary or appropriate. Upon termination, the Client will be responsible for payment for all services rendered up to the termination date. The Church reserves the right to terminate the Contract immediately if the Client engages in disruptive behavior or fails to comply with the terms of the Contract.
9. Dispute Resolution
In the event of any disputes arising under this Contract, both parties agree to first seek resolution through mediation. Mediation is a non-binding process where a neutral third party facilitates negotiation between the parties to reach a mutually acceptable resolution. If mediation is unsuccessful, the dispute may be resolved through binding arbitration or legal proceedings. The arbitration or legal proceedings will be conducted in accordance with the laws of the State of [State]. The prevailing party in any legal action or arbitration shall be entitled to recover reasonable attorney’s fees and costs incurred in connection with the dispute.
10. Limitation of Liability
The Church shall not be liable for any indirect, incidental, special, or consequential damages arising out of or related to the counseling services provided under this Contract. This includes, but is not limited to, any claims for lost profits, business interruption, or emotional distress. The Church’s liability is limited to the total amount paid by the Client for the services provided under this Contract. This limitation of liability is intended to reflect the reasonable scope of the Church’s responsibilities and the nature of the counseling services offered.
11. Governing Law
This Contract shall be governed by and construed in accordance with the laws of the State of [State]. Any legal proceedings related to this Contract shall be conducted in the courts of [County], [State]. This choice of law ensures that any disputes will be resolved according to the legal standards of the specified jurisdiction.
12. Amendments
Any amendments or modifications to this Contract must be made in writing and signed by both parties. No oral modifications or agreements shall be valid or enforceable. Written amendments ensure that any changes to the Contract are clearly documented and agreed upon by both parties.
13. Entire Agreement
This Contract constitutes the entire agreement between the Church and the Client concerning the subject matter hereof. It supersedes all prior agreements, understandings, or representations, whether written or oral, related to the provision of counseling services. No other agreements or promises, other than those included in this Contract, shall be considered binding.
14. Signatures
By signing below, both parties acknowledge and agree to the terms and conditions outlined in this Contract. Each party affirms that they have read and understood the Contract and agree to be bound by its terms.
Provider:
[Your Name]
[Title]
[Month Day, Year]
Client:
[Full Name]
[Month Day, Year]