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Approved Victims Services Declaration Form

 

  • Only people with pre-approval can access this service.

 

  • If you are approved, you are eligible for 22 counseling sessions.

Please review our Terms of Service below and confirm your acceptance of the terms by ticking the box on the intake form. 

Approved Victims Services Declaration

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Please review our Terms of Service below and confirm your acceptance of the terms by ticking the box below and on the intake form.
  • I acknowledge that everything experienced in this practice is not intended to replace orthodox medical treatment, but to be used in conjunction with it. I give consent to enter this process.

  • As a Victims Services Counselling client I acknowledge that I am eligible for 22 counseling sessions. 

  • In the case of 2 or more NO shows will result in I accept that my placement with this counsellor may be revoked and allocated to another person. 

  • If I am unable to attend a session, I agree to contact Faith 48hrs before my appointment time. 

Thanks for submitting!

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