Confidentiality
All interactions which take place in the setting of therapy are considered confidential. This includes requests by telephone, all interactions with this counselor, any scheduling or appointment notes, all session content records and any progress notes that I take during your sessions. You may choose to give me permission in writing to release any or specific information about you to any person or agency that you designate. 

Limits to This Agreement

• In some legal proceedings a judge may issue a court order. This would require this counselor to testify in court.
• If I learn of or believe that there is physical or sexual abuse or neglect of any person under 18 years of age, I must report this information to county child protection services.
• If I learn of or believe that an elderly person, or disabled person is being abused or neglected, I must file a report with the appropriate state agency that handles elder abuse.
• If I learn of or believe that you are threatening serious harm to another person, I am obligated to report this. This can be in the form of telling the person who you have threatened, contacting the police or placing you into hospitalization.
• If there is evidence that you are a danger to yourself and I believe that you are likely to kill yourself unless protective measure are taken, I may be obligated to seek hospitalization for you or to contact family members or others who can help provide protection
• There may be times when I consult with outside sources about cases. In these cases, no personally identifiable information will be used to discuss this case. However, discussion topics will be used in order to ensure that I am getting and giving the best assistance possible. The persons with whom I discuss cases are legally bound to keep information confidential.

Confidentiality and Communication with Parents for Athletes Under 18

• Parental Involvement: For athletes under the age of 18, it is sometimes necessary to involve parents or guardians in the discussion of certain aspects of the athlete's development and progress. This involvement ensures that the athlete receives comprehensive support both within and outside of the training environment.
• Information Sharing: Information shared with parents or guardians will be limited to what is deemed necessary for the athlete's wellbeing and development. The nature of the information to be shared will be relevant professionally, and will focus on aspects such as training progress, health, and any areas where parental support may be beneficial.
• Athlete Notification: Before any information is communicated to the parents or guardians, the athlete will be informed about what will be shared and the reasons for sharing this information. This discussion aims to maintain transparency and trust between the athlete and mental performance coach, ensuring that the athlete is aware of and comfortable with the information being communicated.
• Confidentiality Assurance: All information shared with parents or guardians will be handled with the utmost confidentiality and in accordance with applicable laws and regulations.

I have read and discussed the above information. I understand the nature and limits of confidentiality and agree to the above terms and nature of service. 
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Client Signature Sarah Dannettell Signature 


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Parent or Guardian for clients under 18yrs Date