Participant Agreement
Rock Your Family Counseling Ministries (RYFCM) is a 501(c)(3) public charity non-profit organization dedicated to offering Christian counseling, pastoral, and coaching services and intensive counseling services for individuals, couples, and families. We are also dedicated to serving Christian counselors around our nation to help train and equip them to be able to serve Christ and His people in strength, freedom, and unity of spirit founded upon the rock of God’s Word.
All donations given to our ministry are tax-deductible, minus any goods or services received. You have been comprised and are aware of our Goods and Services, Privacy Policy, and Terms and Conditions.
To be a part of our great mission or to contact us as needed, you may donate or learn more at RockYourFamily.com or send mail or checks to:
Rock Your Family Counseling Ministries, 9235 N Union Blvd., STE 150-274, Colorado Springs, CO 80920
NOTE: We are a donor supported ministry, so we thank you immensely for your support in being part of the story God is writing through RYFC M in this incredible adventure.
CHRISTIAN PASTORAL COUNSELING & COACHING AGREEMENT
In order to be fully informed about the Christian or pastoral counseling or coaching you will be receiving, please read through this following agreement, sign and date it at the bottom. This form must be signed and the intake form must be completed and returned to RYFCM before your first meeting.
DESCRIPTION OF CHRISTIAN / PASTORAL COUNSELING AND COACHING
The goal of Christian pastoral counseling and coaching is to help an individual think biblically about their current struggles in the context of a confidential, caring environment. A Christian pastoral counselor and/or coach relies on Scripture as the sole authority for faith and conduct and recognizes that lasting change is the result of the power of God, the grace of Christ, and the indwelling ministry of the Holy Spirit. Guided by biblical principles, the Christian pastoral counselors or coaches role is to utilize guided questioning, empathetic support, problem definition, contemplation, reflection, reframing, reading assignments, encouragement, admonition, the ministry of the Holy Spirit, the ministry of reconciliation, the ministry of peacemaking, and prayer to provide wise, biblical, faithful, helpful, and strong counsel to those who are hurting, struggling, or may be in need.
QUALIFICATIONS
Our Christian pastoral counselors have varying degrees of education and experience. Please view their online profiles on our website for specific information about the Christian pastoral counselor(s) or coaches you will be working with.
REFERRAL POLICY/DISCLAIMER
After reviewing the intake form and/or conducting a consultation or initial meeting with you or your family, we will determine whether or not we feel we can provide you with the appropriate services and level of care needed. Partakers in our services will be referred outside of Rock Your Family Counseling Ministries to other entities, professional clinics, or life coaching services and so on when treatment required is beyond the scope of care we have available.
CHRISTIAN PASTORAL COUNSELING OR COACHING FEES, NOTES, AND REFERRALS
Please see profile information or inquire of us in writing for your specific Christian pastoral counselor’s or coach’s accurate suggested donation information. Credit card, cash or checks are accepted forms of payment (checks made payable to “Rock Your Family Counseling Ministries”) Scholarships on behalf of our generous donors may be available for those struggling financially if funds exist and qualifications are met.
- Please note that we are unable to bill to or accept any insurance for Christian pastoral counseling or coaching services. We also cannot provide any potential insurance reimbursement receipts for Christian pastoral counseling or coaching. Furthermore, all appointment or meeting notes are kept off record and not submitted to any insurance company or governing authorities for review or auditing purposes and will not be able to be utilized for any legal or court proceedings or purposes. The only exception to this is if we were Court Ordered by Judge. While these may be requested by the client themselves and may be given dependent upon the discretion and approval from our ministry, they may not be requested by anyone else, and we may not surrender them nor be required to surrender them to anyone. Our meeting notes and records are for internal use only.
- Our services and programs are supported entirely by the generosity of our donors. We have some small fees associated with our services that have been substantially reduced from going market rates, so instead we accept donations above and beyond the costs of our services in order to help us continue to operate and grow to further our mission. While some of our services are free, others have rates attached to them because we believe in partnership and working together as the Body of Christ to complete our mission. We do provide discounts or scholarships for those in need in accordance with the funds we have available. All discounted or scholarship services are awarded solely upon need and the leading of the Holy Spirit and the discretion of our ministry.
- We accept people and families as participants of our services or programs in accordance with God’s leading and our discretion as to whether we are a good fit or not and depending upon whether we have the capacity or not.
CIENT EXPECTATIONS
Please plan to arrive on time to your appointments, so the meeting can begin promptly. Remember to cancel or reschedule meetings at least 24 hours ahead of your scheduled meeting time in order to not be liable for the payment of the meeting. You may be asked to complete homework assignments, or purchase a book to be read in conjunction with your Christian pastoral counseling or coaching. In addition, prayer, Scripture reading or memorization may be utilized as part of the Christian counseling or coaching process. Your commitment to the Christian counseling and coaching process will greatly determine the outcome of your experience and is expected by our ministry as part of your agreement in partaking in our services or programs.
MINORS
If you are a minor, your parents may be legally entitled to some information about your partaking in our services. We will discuss with you and your parents what information is appropriate for them to receive and which issues are appropriately kept confidential. At minimum, every minor and parents of that minor agree to a release of information for billing purposes.
EMERGENCIES
We provide non-emergency services by appointment only. You agree to not contact us in emergency situations, but to rather call 911 or the suicide hotline at 988 or your local crisis hotline in your area. You agree to hold us harmless for any emergency you may suffer whether related to our ministry or services we’ve provided or not.
GROUP COUNSELING AND COACHING
We host group counseling or coaching that takes place either in-person or online. You recognize that these services have limited or no confidentiality, and therefore you forfeit all private or confidential matters related to your life or family in accordance with what you choose to share through these services or in these forums. Furthermore, any information you choose to share publicly in these settings allows the ministry to have full rights to share and or utilize in accordance with our discretion for the betterment of our ministry and the goods or services we offer.
EXPERIENTIAL/EQUINE COUNSELING SERVICES LIMITED LIABILITY
Participating in our experiential or equine services may be a potential risk to your health and well-being. These actives have an element of danger and risk. We cannot assure the safety of clients in all circumstances. You participate at your own risk and of your own will, and by signing this document you agree to not indemnify or hold liable Rock your Family Counseling Ministries or any staff members in any way for any harm or injury that may arise in association with your or your family member(s) participation in this form of enrichment counseling.
INCLEMENT WEATHER
In order to continue the progress of your services, we will conduct your meetings remotely via phone or video if you are unable to travel to any of our counseling centers or physical locations. If your counselor or coach decides a remote meeting is not appropriate for your progress, then your meeting may be rescheduled accordingly.
CONTACT INFORMATION
Any means of contact you provide to us is considered legitimate to use by our organization or staff in contacting you for any reasons we deem appropriate. You agree that as a client your email will be added to our e-newsletter and/or client contact list and any other internal marketing lists we may have that we believe may be appropriate or beneficial to you or your family or someone you may know. You may unsubscribe from any of these lists at any time at your discretion.
CONFIDENTIALITY
Your Christian pastoral counselor or coach will adhere to commonly accepted codes of privacy and confidentiality in counseling ethics, except when any of these conflict with the Word of God. There are situations in which the law requires that certain information can be revealed without your consent. Under the discretion of the Christian pastoral counselor or coach, if there is any indication that you may be a danger to yourself or others, suicidal, or are suspected of being involved in the neglect or abuse of a minor, your information may be disclosed to appropriate mental health services or law enforcement or governing bodies. Also, an issue may occasionally arise that would benefit from the counsel or involvement of another pastor or counselor or coach at or outside of our ministry. If deemed appropriate, your Christian pastoral counselor or coach may decide that another staff member or outside external professional or person be consulted to insure the quality of care you are receiving. Furthermore, if you are involved in any of our marriage or family counseling or coaching services or programs involving more than one member from your family or a significant other then your Christian pastoral counselor or coach may choose to inform select family members or others at his or her discretion of any necessary or relevant information pertaining to your or their counseling or coaching for the benefit of unity, open communication, removal of unseen or unknown obstacles, or for any other reason that the counselor or coach deems worthy to attempt to bring about healing, progress, growth, or change. Lastly, if you partake in any experiential counseling services, then these may have limited confidentiality associated with them because they sometimes take place in public settings or other environments that other people may be associated with, and therefore, you agree to this limited confidentiality setting if you partake or your family partakes in any of these services. Lastly, you forfeit all rights to privacy for anything you choose to share in a group, online group, or public forum setting.
RIGHTS AS A CLIENT
1. You are entitled to information about any procedures, methods of Christian pastoral counseling or coaching, techniques and possible duration of counseling or coaching if that can be determined.
2. You have the right to end Christian pastoral counseling or coaching at any time without any moral, legal or financial obligations other than those already accrued or agreed upon.
3. You have the right to expect confidentiality within the limits described.
4. You have the right to authorize your Christian pastoral counselor or coach to consult with another party or professional about your counseling in writing besides any that we have already deemed worthy to consult with.
MEDIATION AND ARBITRATION
Disputes arising out of or in relation to this agreement to provide services shall first be referred to mediation, before, and as a precondition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement of the pastoral counselor and client. The cost of such mediation, if any, shall be split equally.
CANCELLATION POLICY
We request that you notify your pastoral counselor or coach at least 24 hours before your scheduled appointment time if you need to cancel a session. Failure to do so will result in payment of any fees due as described in our terms and conditions or goods and services webpage. Also, in certain situations the cancellation of future appointments or of no longer being allowed to partake in any of our services or programs may occur if you break any of these agreements in this document or if you or your associated family member miss too many appointments. Exceptions are at the discretion of our ministry and may be for things like sudden illnesses and emergencies only.
AUDIO/VIDEO RECORDINGS
You agree to never audit or video record any sessions or meetings or any potential client to staff interactions without the expressed written permission from both your counselor and coach and their supervisor. While various states have differed legal rules and limits on recordings, we as an organization hold a strict rule that this is never appropriate. Any non-compliance to this can at minimum mean immediate client termination and/or appropriate legal action taken to remedy the situation to the maximum extend of the law.
DOWNLOADS/PRODUCTS/FORMS
If you download or purchase any product, file, or form from our ministry, you agree to not duplicate it in any way for sale or benefit to yourself or to not use it in any way that may be detrimental or harmful to our ministry.
CONTACTING ROCK YOUR FAMILY COUNSELING MINISTRIES
For all inquiries or any needs you may have regarding donations, scheduling, meetings, groups, or anything else related to your Christian pastoral counseling and coaching care, please contact us via our website.
I AM AGREEING ON BEHALF OF MYSELF AND MY FAMILY UTILIZING ANY ROCK YOUR FAMILY COUNSELING MINISTRIES SERVICES OR PROGRAMS THAT I HAVE READ, UNDERSTOOD, AND AGREE TO ALL THE ITEMS CONTAINED IN THIS DOCUMENT AND THAT I NOR MY FAMILY WILL INDEMNIFY NOR HOLD LIABLE ROCK YOUR FAMILY COUNSELING MINISTRIES OR ANY OF ITS STAFF FOR ANY HARM OR INJURY THAT MAY ARISE IN ASSOCIATION WITH PARTAKING IN ANY OF OUR SERVICES OR PROGRAMS OR IN UTILIZING ANY OF THE COUNSELING OR COACHING RECEIVED.
Thank you and God bless,
Jordan Hall, Founder