I voluntarily apply for and consent to receiving psychotherapeutic services, either for myself or for my dependent, including evaluation, assessment, diagnosis, and treatment by S.O.A.R - Seeing Our Adolescents Rise clinical staff. Additionally, I am aware that psychotherapeutic, counseling services are not based on an exact science and that the type(s) of treatment I receive will depend primarily on my own needs and abilities. I understand that, as such, I cannot be given any guarantees about the results of any of these services. Further, I also understand that I may withdraw this consent at any time.

I understand I am an active participant in the process of establishing, evaluating, and accomplishing my goals for therapy. I will do my best to communicate my ideas, thoughts, feelings, needs, likes, and dislikes. I understand that by naming and negotiating my needs openly and clearly, and by bringing my full attention to this process, I am empowered to respect and care for myself.

I understand that making a commitment to therapy facilitates an environment that enables me to reach the goals I have established with my therapist. If at any point I do not feel I can continue to commit to these agreements, I will inform my therapist.

Adventure, nature, and wilderness therapy is a type of therapy that uses experiences to help me grow and lead a satisfying life. Adventure Therapy can be done indoors, outdoors, individually and with groups. Sometimes Adventure Therapy includes games and group activities, and at other times it includes sports like rock climbing, biking or hiking. The focus of Adventure Therapy is to learn more about myself through the experiences I will have, creating meaningful relationships with my peers and therapist, and to learn and practice skills that are part of my therapy, such as communication, problem-solving, and recognizing and managing emotions. Even though I may have already done many of the Adventure Therapy activities before, I understand that my focus will be on myself and my own goals for therapy.

SOAR’s Adventure Therapy program requires a 12-week commitment where clients, in a group setting, are asked to use adventure and activity-based interventions to assist them in reaching the goals established through the program. Adventure interventions assist clients in identifying and assessing their responses to a variety of situations, increasing their awareness of their own strengths as well as the impacts of trauma on their behavior. Additionally, adventure interventions allow clients to practice new skills for responding to situations, increasing the likelihood that they can incorporate these skills into their life outside of sessions.

Sessions are limited to weekly group counseling sessions and once a month check-ins. In case of emergency, please call the local 24-hour hotline number…
Expectations of you as a group member include, but are not limited to, active participation in the counseling process, arriving to appointments on time, attending group every week, and informing the adventure therapy team if you are unable to make a session.

Although the therapist is bound to the ethical standards of confidentiality, group members are not. However, confidentiality is considered vital for the work of the group.  Group members are asked to respect one another’s confidentiality and not share information about the group outside of group, especially in public domains such as social media. If a group member has an issue with something that is happening in the group, they are to communicate to their providers and families in order to address issues.
I acknowledge that there are risks to participating in group therapy, including risks that group members may not respect my confidentiality or may engage in behaviors or actions that are upsetting or harmful to other participants, including myself.
By signing this document, you agree to keep the matters discussed in group confidential.

S.O.A.R - Seeing Our Adolescents Rise understands that, as a caregiver, you are concerned and may want to know about the content of your child’s therapy sessions. Because privacy is often crucial to successful progress, particularly with young people, S.O.A.R - Seeing Our Adolescents Rise clinical staff may request that caregivers agree to not ask for specific information disclosed in therapy sessions. S.O.A.R - Seeing Our Adolescents Rise clinical staff will provide only general information regarding progress, rather than specific details. It is our experience that youth progress better if they know that their parent(s) or guardian(s) will not know the specifics of discussions. Exceptions will be made in accordance with HIPAA and the limits of confidentiality. Of note however, in sessions with family, we will make every attempt to encourage your child to openly share information as appropriate to facilitate their care, and your family’s progress towards your child’s wellness goals.

I understand that information will only be shared in accordance with HIPAA regulations.

I understand that S.O.A.R - Seeing Our Adolescents Rise clinical staff has specialized knowledge in nutrition and/or fitness and might ask about my nutritional intake or fitness practices. I also understand that they may even suggest outside sources for further consultation in these areas.

I understand that when such suggestions are offered they are provided merely as avenues for further exploration and are not meant to be seen as prescriptions, directives, or therapeutic mandates of any sort.

I understand it is my responsibility to seek out and consult with appropriately trained professionals for further information about any of the suggestions offered to me by S.O.A.R - Seeing Our Adolescents Rise clinical staff.

I understand clearly that I am not a medical “patient” of S.O.A.R - Seeing Our Adolescents Rise and will not be “diagnosed,” “cured,” “treated,” or “prescribed” any medications for my ailments, diseases, health, or lifestyle as this is considered practicing medicine without a license. I understand that S.O.A.R - Seeing Our Adolescents Rise clinical staff are not licensed to practice medicine and any suggestions for nutritional or fitness support should not imply so.

I understand that telephone calls and electronic communications can be received at any time via telephone, telephone voice mail, and/or email. It is important to note that when calls ring into voice mail, the messages are picked up regularly and will be returned as soon as possible. I understand that S.O.A.R - Seeing Our Adolescents Rise is not a crisis or emergency response center. If I have a major emergency and cannot reach S.O.A.R - Seeing Our Adolescents Rise clinical staff, I am aware that I may need to seek help at a mental health center or a local hospital. Within the Denver metropolitan area, I can always access assistance by dialing 9-1-1 on my telephone or text

TALK to 38255 to reach CCTS or call 844-493-8255
to speak with a Colorado Crisis Counselor.

I understand that at least 24 hours advanced notice must be provided if I need to cancel or reschedule a session. Any cancellations or no-shows are reported to the referring agency, which may impact reauthorization of services. I understand that if I do not regularly attend S.O.A.R - Seeing Our Adolescents Rise programming I may lose the opportunity to participate in S.O.A.R - Seeing Our Adolescents Rise services.

I understand that if I feel I am approaching readiness to leave therapy I will speak with S.O.A.R - Seeing Our Adolescents Rise clinical staff regarding this. Likewise, if my therapist feels I am approaching readiness to leave therapy, this will certainly be discussed with me as well. Additionally, my progress and status will also be discussed and reviewed with me on an ongoing basis.

I understand that I may seek a second opinion from another therapist or may terminate therapy at any time. If I do decide to terminate therapy, I agree to inform my therapist as far in advance as possible, or if this is not possible, at the beginning of the last session at which I am to meet. In a therapeutic relationship of any length, termination and closure are very important processes and most people find their experience to be incomplete if  there has not been an adequate opportunity to discuss the reasons for ending. Advance notice also allows both me and my therapist to pace the therapeutic process appropriately.

By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and SOAR - Seeing Our Adolescents Rise (hereafter referred to as your "SOAR". You are also confirming that you are the parent/guardian authorized to enter into this Agreement. You further agree that selecting "1 Accept" constitutes your agreement to be bound by the terms and conditions of these Disclosures and Agreement as they exist on the date of your E-Signature on this form.

By selecting the “I Accept” button, you specifically agree to receive, obtain, and/or submit any and all SOAR documents and information electronically. These documents and information will be collectively known as "Electronic Communications," and will include, but not be limited to, any and all current and future required notices and/or disclosures or consents concerning SOAR clients, team members, volunteers, interns, and/or parent/guardian, as well as such documents, statements, data, records and other communications regarding your interactions with the SOAR organization. You are acknowledging that you are able to use SOAR's website and are able to retain Electronic Communications by printing and/or downloading and saving this Agreement and any other agreements, Electronic Communications, documents, or records that are signed using your E-Signature. You accept Electronic Communications provided via email as reasonable and proper notice for the purpose of fulfilling any and all rules and regulations, and agree that such Electronic Communications fully satisfy any requirement that communications be provided to you in writing or in a form that you may keep.

• Electronic means technology having electrical, digital, magnetic, wireless, optical, electromagnetic, or similar capabilities.
• Electronic Signature means an electronic symbol or process attached to, or logically associated with, a record and used by a person with the intent to sign the record.
• Client File means the paper and/or electronic record pertaining to the client, including but not limited to the verification worksheet and all documents used to determine the client’s eligibility for SOAR services.
• System means a data processing or client information system used to create, store, sign, retrieve and/or manage the documents or records that constitute the client file.
• System Rules mean rules that apply to all participants using a particular system. For example, such rules might cover issues relating to access rights, distribution of system risk, sending and receiving electronic documents, intellectual property rights, and remedies for breach of system rules.

You acknowledge and agree that you may request a paper version of this consent document by printing or saving a copy to your computer and/or by contacting a SOAR team member directly.

You have the right to withdraw your consent to submit communications via emailing SOAR or in writing at any time. You acknowledge that you are aware this action may delay the process of reviewing your file or working with the client. If you wish to withdraw your consent, you will contact a SOAR team member directly or email us to let us know that you will be forwarding a written request.

We recommend that you print a copy of this Agreement for future reference.
At the end of this document, you will be asked to provide an electronic signature.
Clients and their parents/legal guardians are urged to carefully read the terms and conditions of this Agreement. Please keep all records relating to this Agreement and print or make an electronic copy of the Terms and Conditions.