Counseling Agreement

Thank you for your interest in counseling at Denver Counseling and Coaching (DCC). We look forward to the opportunity to serve you. In order to be as clear as possible about the counseling you will be receiving, we have created this counseling agreement. Please read the agreement, check "Accept" in each section, sign & date, then submit before your first appointment.

Description *
DCC provides Biblical counseling. While this does not mean that you have to be a Christian to receive counsel, it does mean that your counselor will be counseling you from the Bible. Your counselor is trained in both Scripture and counseling. DCC counselors are NOT LICENSED psychologists or licensed professional counselors.
Counseling Fee *
DCC charges a counseling fee between $110 and $175 per session, or coaching fees between $150 and $300 per month. Additionally, counselors may request clients to complete a behavioral assessment prior to their initial session. We have a sliding scale to assist clients during financial hardship.
Please select which Counselor you are interested in seeing.
Confidentiality *
DCC is very sensitive to the issue of confidentiality. To release confidential information without your consent would violate both commonly accepted codes of counseling ethics and biblical standards. There are 3 situations, however, where it may be necessary for us to share certain information with others: when there are clear indications that someone may be harmed, when a child is being sexually or physically victimized, or when a person who is a member of a church persistently refuses to renounce a particular sin and it becomes necessary to seek the assistance of others in that church to encourage change (cf. Matthew 18:5-10).
Missed Appointments *
DCC seeks to keep our counseling fees as low as possible, so please do everything possible to avoid cancellations. With the exception of emergencies, cancellations that occur less than 24 hours before the appointment will be charged to you at one-half the standard hourly rate.
Acceptance of Agreement *
Acceptance of Agreement
To accept and enter into agreement with Denver Counceling and Coaching, please complete below Name and Date.
Date *