Consent Form | Mind Soul Haven

We are a counseling service specializing in various counseling. We value our relationship with our clients and believe that such a relationship is the beacon in the healing process.

Before beginning your sessions, it is important to ensure that you fully understand and agree to the terms of our therapeutic relationship. Please read the following information carefully. By signing/submitting this form, you acknowledge that you have understood and agreed to the outlined terms and conditions.

Nature of Services

The services provided may include counseling, hypnotherapy, psychological assessments, or a combination of these based on your individual needs. These services support your personal growth, emotional well-being, and mental health. Please note that therapy is a collaborative process and does not guarantee specific results.

Confidentiality

Your privacy is of utmost importance. All information shared during sessions will remain confidential under the principles of the counselor-client relationship. Any of the information will not be shared or revealed to any person, agency, or organization without the prior written consent of the client within limits provided by law, with the following exceptions as required by law:

If you pose a danger to yourself or others.
In cases of suspected domestic violence, child abuse, elder abuse, or abuse of a vulnerable adult.
If records are subpoenaed by a court.

You may also provide written consent to release your information to a third party, such as another healthcare provider or family member, if necessary.

Session Structure and Fees

Sessions duration, and the fee for each session is mentioned in our service page.
Payment needs to be confirmed at the time of service unless prior arrangements have been made.
Cancellations or rescheduling must be made at least [24/48] hours in advance. Failure to do so may result in a missed session fee.

Client Rights

You have the right to ask questions about the methods, what to expect and approaches used during sessions and end results of the therapy.
You may decline to proceed the therapy anytime, without any impediment and may return to therapy anytime.
You may withdraw consent and discontinue therapy at any time.
You have the right to refuse any specific intervention or treatment without repercussions.
You have the right to review your records from the therapist.
The therapist has right to dismiss the client from the course of therapy.
Referrals: If you have a particular concern needing a specialized treatment approach (eg. a couples therapy, EMDR therapy, family therapy, sex therapy, alcohol or drug problems specialist etc.), therapist has right to refer the client to another specialist in the respective field.
Consultation: Anonymous supervision will be carried out with the therapist's supervisor.
You can raise any concerns and to speak with the therapist immediately of any concerns provided that the therapist is likewise available to discuss the matters with the client.

Hypnotherapy Disclaimer

Hypnotherapy is a complementary therapy and not a replacement for medical or psychiatric treatment. It is recommended that you consult with your healthcare provider before beginning hypnotherapy if you have a medical or mental health condition.

Emergency Situations

The services provided are not intended for crisis or emergency situations. In the event of an emergency, please contact local emergency services or reach out to a crisis hotline.

Acknowledgment and Consent

By signing/submitting below, you confirm that:

You have read, understood, and agreed to the terms outlined above.
You are voluntarily seeking counseling, hypnotherapy, or psychological services.
You understand the limits of confidentiality and the nature of the services provided.

We believe that each individual is unique and has his own way of addressing resolutions. Thus, we believe in a wellness model that helps our clients empower themselves by focusing on what works for them and not in a systematic approach that provides a generic procedure on working on a treatment. One's journey is not the same as other.