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Consent For Consultation
I understand I will be speaking with a Registered Associate Therapist or a Intern/Trainee Therapist who works under the supervision of Discovery Counseling Center's certified licensed Supervisors with whom cases are discussed.
The therapist-client relationship and any information shared in therapy is confidential. I understand information will only be released with my written permission (which may be revoked in writing). According to California law, therapists are mandated reporters and must breach confidentiality under the following circumstances when there is a reasonable suspicion of:
A. An incident of child abuse, past or present
B. An incident of elder abuse or dependent adult abuse
C. Serious threat of harm to oneself or to others or to property
D. Certain other legal situations, such as a court order or a court-ordered evaluation
NOTICE OF PRIVACY PRACTICES
If this is an emergency call 9-1-1 or the emergency Psychiatric services at 408-885-6100 or go to the nearest hospital emergency room.
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