(1) The counseling is biblical in nature and is not part of a licensed and/or professional discipline  governed and/or regulated by any governmental agency. 

(2) The Counselor is not acting in the capacity of a licensed or certified psychotherapist, psychologist,  psychiatrist, mental health professional, marriage and family therapist, or social worker. 

(3) The Counselor is not providing legal, tax, financial, medical, or other technical or professional advice and the Counselor undertakes no duty to recognize or opine when such advice is actually needed, and the parties  further agree that no fiduciary or professional client relationship is being created between the Counselor and the Counselee as a result of this relationship. 

(4) This biblical counseling is a ministry of the Gospel of Jesus Christ and is part of Counselor’s practice of the Christian religion and is being sought voluntarily by the Counselee as part of the Counselee’s practice of  the Christian religion. 

(5) It is intended that the Holy Scriptures (the Bible) shall be the authority governing the counseling  process, and that God’s glory is the ultimate goal. However, failure of Counselor to interpret or apply  the Bible in any particular way shall not subject Counselor to liability, or give rise to complaint by  anyone. There shall be no legal or other liability that attaches to Counselor or any related institution or  person for any advice, methods, conduct, or any act or omission related in any way to the service that is  provided, and Counselee acknowledges that Counselee is voluntarily seeking this counsel (free from  coercion, duress, or pressure) with a full understanding of the nature, purpose, and effect of this  agreement. 

(6) At any time and for any reason, Counselor or Counselee may terminate counseling. However,  termination will not preclude Counselor from making the disclosures set forth below if deemed  appropriate by Counselor, or if compelled by other legal means. Counselor is not required to keep  records, but if records are made, Counselor may destroy any such records without incurring liability. 

(7) Confidentiality is conditional. Although confidentiality is often one aspect of the counseling process  and Counselor intends to guard the information received from Counselee, there are a number of  situations when it may be necessary or prudent (as determined in Counselor’s sole discretion) for  Counselor to share information with others. Counselee agrees that Counselor may share information in  at least the following circumstances:

• When the Counselor is uncertain how to address a problem and needs to seek the advice from a pastor,  supervising counselor, or educator. (Proverbs 11:14; 24:6). 

• When there is concern that someone is being or may be harmed unless other persons or protective  services intervene (Romans 13:1-7). 

• When the Counselee expresses clear and specific suicidal intent, Counselor may take reasonable  measures for the safety of the Counselee. Reasonable measures may include notifying police if the  the Counselee will not cooperate to involve him or herself in a watch-care program or facility. 

• If the Counselor has reasonable cause to believe that an adult is in need of protective services,  Counselor may take reasonable measures to prevent harm. Reasonable measures may include directly  advising the potential victim of a threat or intent and/or informing the appropriate protective and/or  law enforcement agencies. 

• If there is a claim of, the observance of, or clear reasonable cause to suspect the physical or sexual  abuse of a child with whom Counselor comes into contact or who is associated with someone to  whom Counselor is in contact with, reasonable measures may be taken to ensure the child’s  protection and/or to fulfill the legal mandate to report such harm to the appropriate governmental  protection agencies. 

• When the Counselor becomes aware of any other criminal activity the Counselee is engaged in and the Counselee refuses to bring to the appropriate biblical and/or legal authorities. 

• When counseling someone who is under familial authority (e.g. wife to husband, child to parent)  and if deemed safe by Counselor, Counselor may encourage the Counselee to inform the Counselee’s familial authority of critical issues and/or Counselor may inform the familial authority (Ephesians  5:22- 6:4). 

• When counseling someone who is under academic authority or referred by Student Life, where  discipline issues according to the student handbook apply, or an issue arises that may effect the  academic standing of the Counselee. 

• When a person refuses to renounce a particular sin and/or refuses to confess it to those impacted,  Counselor may in Counselor’s discretion, seek the assistance of a trusted member or leader of any  involved church to encourage repentance and/or reconciliation (Proverbs 15:22, 24:11; Matthew  18:15-20). 

• When the Counselor deems it appropriate or necessary to discuss information with a training observer  or an assisting advocate who is involved or observing counseling. 

• When the Counselee makes a complaint against the Counselor, an ACBC counselor, or a counseling center or other related organization, it is agreed that the dispute will be handled biblically, outside the court, and may involve sharing information with an assisting local Church Shepherd and/or the appropriate  person(s) within the ACBC organization for complaint resolution purposes.

Please be assured that our counselors strongly prefer not to disclose your personal information to  others (if not needed), and they will make every effort to help you find ways to resolve a problem as  privately as possible.

This release, waiver of liability, and confidentiality agreement is being made and entered into by the client between (Madeline Crawford) on the entered date.