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Memorandum of Understanding
Ethics, legal compliance, appointments, service guarantee
Make sure you understand these ethics, legal compliance, appointments, and service guarantee points. Then, we can fly :-) not before.
Consent for Minors
You must be at least 18 years old to use the services of Christian-Based Counsel, Donna Gray-Davis, MSMFT. If you are not 18 years old, ask your parent or guardian to e-mail a request for a Consent for Services at NO CHARGE. I must have an originally signed copy before we begin working together.
Confidential Clinician
As a clinician I am required to maintain confidentiality in regard to anything you disclose, except in cases of a "Duty to Warn" (see below). However, you may request a release of information to disclose information about our sessions to an outside source. Just send me an e-mail request at NO CHARGE. I have taken every precaution possible to keep your information private and secure. When using the services, take caution as to whether or not any one else has access to your message (Family, friends, or co-workers). Use a method to which only you have access.
Intended Use
While the services provided to you through business.gorge.net/CBC are therapeutic, they are NOT intended to take the place of traditional face-to-face therapy or to be used as a substitute for conventional clinical assessment or treatment.
CBC is intended for people who are confronting personal transitions and normal obstacles in life. Use Christian-Based Counsel before your issue becomes a crisis.
If you are in crisis, call your local crisis hotline or dial "911."
Duty To Warn
Any information that you disclose to me is kept in extreme confidence, except in the following cases:
Immediate threats of suicide or homicide
Abuse of a child or elderly person
A medical emergency condition
Service Outages
In the event of computer, server, or telephone outages, I will make every possible effort to respond to you in a timely manner. If I have not responded that means I didn't receive your request. If you have not received a response within the specified turnaround time, call my confidential voice mail, at (541) 386-4450.
Service Guarantee
If for any reason I am not able to fulfill your service request, you will be fully refunded for that particular service. If you are not satisfied with the substance of my response, we will discuss your concern, then I will send you a second response at NO CHARGE.
Donna
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