Consent to Services

Hey there,

Before we start our journey together towards restoration, we need your agreement on the services we're planning to provide. This will include the methods we're going to use, the potential benefits and risks involved, and any other options you may have. It's important you know that all information shared will be confidential. This is our 'Bridge to Restoration' consent, meant to keep everything clear and mutually agreed upon. Thank you for understanding and cooperating!

Email *
Counselling
Clear selection
Assessment
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report