Description of Counseling: The mission of Cornerstone Counseling Ministries is to provide Christ-centered counseling services to individuals, families, the church body, and community. We are committed to developing solutions with our clients to address their physical, personal, emotional and spiritual wellbeing. We look to Christ as our model, relying on the Holy Spirit’s guidance and power to bring about transformed hearts and renewed hope for the glory of God. Although counselors at CCM are guided by a Christian worldview, your counselor will be sensitive to your religious/cultural differences and perspectives. Based on your counseling needs, you may be advised to take appropriate tests/inventories or seek medical treatment to facilitate the counseling process. The licensed counselors at CCM adhere to the Code of Ethics as prescribed by the American Counseling Association and the American Association of Christian Counselors. Pastoral counselors adhere to the ethical and moral duties as set forth in the following scriptures: Proverbs 3:27; Matthew 22:37-40; John 15:12-17; 1 Corinthians 13:1-13; 1 Thessalonians 2:1-12; James 2:14-17; 1 John 2:7-11 and 3:11-24.
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Referral Policy/Disclaimer: Clients will be referred outside of CCM when treatment required is beyond the scope of care available at CCM. Though CCM strives to be responsible and professional in the referral procedure, it is your full right and responsibility to select the professional of your choice. CCM is not liable for any services provided or not provided by the referred professional.
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Counseling Fees: Please reference our fee schedule that includes an option to take part in our Stewardship Program which is available for those with a qualifying income level. To be considered for our Stewardship Program you must provide verification of income, such as the most recent tax return. Payment is due at the beginning of each session and accounts must be kept current to continue counseling at CCM. Cash, credit cards, or checks are accepted forms of payment (checks made payable to Cornerstone Counseling Ministries). ***Please note that we are unable to accept insurance. ***
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Confidentiality: To release information without your consent would violate commonly accepted codes of counseling ethics. There are situations, however, in which we are required by law to reveal information without your consent. Please see the “Notice of Policies and Practices to Protect the Privacy of Your Health Information”. All counselors at CCM participate in regular peer supervision and some participate in additional supervision and/or consultation. During this supervision or consultation your personal identity will be concealed but the aspects of your concerns may be shared to solicit appropriate guidance from the supervisor. The purpose of supervision is to ensure quality of care received at CCM.
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Rights as a Client: 1. You are entitled to information about any procedures, methods of counseling, techniques and possible duration of counseling. 2.You have the right to end counseling at any time without any moral, legal or financial obligations other than those already accrued. 3.You have the right to expect confidentiality within the limits described in the Notice of Policies and Practices to Protect the Privacy of Your Health Information. 4.You have the right to request in writing the release of your records to any person or agency. 5.You have the right to authorize your counselor to consult with another professional about your counseling in writing. 6.You have the right to file a grievance in writing with the Executive Director of CCM if you have concerns that your rights as a client have been violated.
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Mediation & Arbitration: All disputes arising out of or in relation to this agreement to provide services shall first be referred to mediation, before, and as a pre-condition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of the counselor and client. The cost of such mediation, if any, shall be shared equally.
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Cancellation Policy: CCM requests that you notify your counselor at least 24 hours before your scheduled appointment time if you need to cancel a session. Failure to do so will result in charges for the missed appointment. This charge should be paid before or at the time of your next appointment to continue in the counseling relationship. Exceptions are for sudden illnesses and emergencies only.
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Contacting Your Counselor: For scheduling and canceling your appointments, you must contact your counselor directly by dialing CCM’s main number 610-295-9499 and then leave a message. Your call will be returned within 24 hrs. For emergencies after-hours, please contact 911, or your local emergency room.
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Social Media: During the duration of a client’s treatment at CCM, the counselor will not engage in a social media relationship with the client and/or communication with a client through any social media platform. Counselors will clearly explain to their clients, as part of the informed consent procedure, the benefits, limitations, and boundaries of the use of social media.
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Case Consultation: Information shared in a consulting relationship is discussed for professional purposes only. When consulting with colleagues, counselors do not disclose confidential information that reasonably could lead to the identification of a client.
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In the interest of full disclosure about the counseling I will be receiving, I hereby declare that I have read and agree to this entire document. This form must be signed and included with the intake form in order to begin counseling.
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If the client is under 18 a parent/guardian must also sign.
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