By submitting form, I acknowledge the following:
I acknowledge that certain services may only be available to me if I am a low income earner. I understand I may be required to provide proof of low income. If choosing to see an intern, I acknowledge that I have not been able to access services through the agencies responsible for publicly funded counselling. I understand that these services have a maximum number of sessions (will be reviewed at 12 sessions).
I am aware there are waits based on service I chose - and that the therapist will attempt to call me as well as email me, and that if I do not follow up within one week that the file may be closed.
When a client is at risk for or has attempted suicide, and a Moving Forward Family Services Society staff member becomes aware of this, the staff member will do the following:
1) Promptly disclose this information to their Clinical Supervisor, Manager and the Executive Director
2) Provide an assessment of the situation
3) Determine the risk of danger to others: this encompasses family members, acquaintances, and the client
4) In the circumstance in which the client is a minor the staff member will initiate contact with the minor’s parent or guardian and appropriate ministries if applicable.
5) In the occurrence of an attempt of suicide, a contact to the local authority will be made and appraisal of the situation will be disseminated to the authority
6) If required call an ambulance or contact an appropriate agency for crisis intervention
7) Ensure highest measure of confidentiality by only initiating contact with other agencies on a need to know basis such as school officials, counselors, mental health professionals, or family physician.
8) In collaboration with all involved professions institute a follow up procedure to ensure a level of communication exists among all personnel
9) Supervisor is notified as soon as possible
I understand that if I am choosing a service with an intern, they may have limited prior experience and cannot offer specialized services, such as psychological assessment. They also will not provide detailed letters for court/probation/social worker.
A basic letter outlining number of sessions and generally what was discussed in sessions can be provided free of charge - such a letter must be requested a minimum of four weeks before it is required. Any request made with a shorter deadline will be subject to an administration fee of $50.
While a basic letter can be provided free of charge, a request for the complete client file will be charged a minimum administration fee of $75.
Once an appointment is made, I will make every effort to attend. I will provide a minimum of 24-hours advance notice if I cannot attend. I understand that missed appointment fees may be charged and/or services will be discontinued if I miss multiple (two or more) appointments. If a service is discontinued due to missing multiple sessions, an administration fee to reactivate file of $20 will be administered.
I understand that while services are offered across Canada, MFFS is based in British Columbia, Canada, and follows provincial laws related to service agencies.
I understand that services are fee-based, with limited free services reserved for those who do not work
I understand Moving Forward Family Services will deny services to anyone who acts aggressively (physically or verbally) towards our team
I understand Moving Forward Family Services will deny services to anyone who expresses views that contradict human rights as outlined in the BC and Canadian Human Rights Code