You understand that while pastoral guidance and life coaching is a from of counseling for encouragement and growth, I am not a clinical psychologist, psychiatrist, medical doctor, lawyer or licensed social worker. I cannot prescribe medicine or diagnose illness. All advice or coaching given to you is done so in good faith, in the spirit of scriptural principles and practical wisdom to support your emotional and spiritual well-being, in hopes that you will use good judgment and practical applications when appropriate, to the degree that you feel capable and comfortable. In addition, it may be suggested that you seek help from your personal pastor, clinical counselor, a medical doctor or psychiatrist for more deep seeded issues.
You agree that neither your counselor/coach, in this case, Brad Sullivan, or any of his associates, are responsible for providing services to you in the event of an “urgent” crisis or emergency situation. This should NOT be an expectation of my services. While I will do my best to provide kindness and concern, only as appropriate, if a crisis or emergency develops during our work together, you may need to seek the help of a medical professional or a clinical mental health professional.
CONFIDENTIALITY: You understand and agree that in providing personal guidance, I protect the confidentiality of the communications and contacts with all of the people with whom I work. I will only release information about our professional relationship with your written permission except in the following situations:
a. If it is discovered, while we are working together, that a child, elderly person, or disabled person is being abused or neglected, I am required by law and morality to notify appropriate protective services, agencies, or law enforcement officials.
b. If I am required to do so by a court order or legal subpoena or if you choose to pursue litigation against Brad Sullivan, or anyone associated with this organization. We will defend claims against us vigorously. You agree, by signing this form, to pay any and all expenses of our legal defense and any financial losses as a result of such including, but not limited to, injury to reputation or defamation by means of special damages. Furthermore, you specifically agree to mediation by an objective third party as a means of resolving conflict with Brad Sullivan, rather than litigation at your expense.
c. If you tell me while we are working together that you are considering committing suicide, committing serious self-injurious behavior, or considering violence towards another person, or you demonstrate symptoms of delusions or hallucinations or appear in a session to be under the influence of a substance that inhibits your ability to drive or care for yourself, I am required by law and/or morality to notify the appropriate authorities and/or family members. Be forewarned that self-harm or threats to others, neglect, abuse, including extremely harmful addictive behaviors/overdosing, and/or perceived psychoses are taken very seriously and additional help, such as medical or legal intervention, may be necessary and may not require your additional consent or prior knowledge to do so.
1. The goal is to help you. Therefore, if either of us feels, at any time, that working together is not helpful enough to you; either of us is free to terminate our relationship. There are no explicit or implicit commitments in our relationship.
2. You agree to never record counseling sessions, through audio recorder, phone, video, or any other means, covertly or otherwise. You also agree to me having witnesses sit in on our session. When meeting with a man, I will have another man present. When meeting with a woman, I will have another woman present.
3. You agree that this relationship is best served if there is no legal basis for acquiring testimony for any purpose, including but not limited to, divorce, custody, and abuse cases. You agree that you will NOT subpoena your guidance provider for any purpose or “invite” me to testify on your behalf, under any circumstances, as this is a violation of your privacy and the sanctity of our professional relationship.
4. The sessions we have together are paid in full in advance with no refunds.
