Counseling Intake Form

Thank you for filling out this intake form. This will be given to your counselor prior to your first first counseling meeting.
 
 
 
 
 
Counseling Consent


I/We desire to receive counseling from CrossPoint Fellowship Biblical Counseling and therefore make the following acknowledgements and agreements and give the following consents: 
-The counseling will be by a counselor who is trained in biblical counseling who may or may not have other certification or degrees. 
-A basic principle of biblical counseling is that the Bible is sufficient to understand how to live a God-pleasing life. 
-The counseling I/we will receive will be based upon Scriptural principles rather than principles of psychology or psychiatry. 
-The counseling I/we will receive will be based on the conclusions that the Bible is inerrant and authoritative and contains God’s answers to the issues of life, conduct and relationships. 
-The counseling I/we will receive will reflect the counselor’s understanding of the Bible and how the principles of Scripture apply to the problems, questions or issues involved. 
-CrossPoint Fellowship Church not only does counseling but also trains biblical counselors; this means that the counselor may have one to two people observing him/her in each counseling session. 
-Absolute confidentiality is not Scriptural.  Counseling at CrossPoint Fellowship Church, including statements made during counseling, shall remain confidential, with the following exceptions; 
-Counselors shall be free to discuss counseling sessions and cases with other CrossPoint counselors and the pastors of CrossPoint Fellowship Church, in order to gain the benefit of additional insight and input; 
-Counselors and pastors shall be entitled to seek a confidential legal opinion or advice from an attorney when it is deemed appropriate and helpful; 
-If any CrossPoint Fellowship Church policy concerning the reporting of child abuse
or child neglect, or the reporting of elder abuse or elder neglect, mandates a report to Child Protective Services or other authorities in compliance with the laws of the State of Indiana, then such report will be made;
 
-If a suicide risk is indicated, the counselors or pastors may seek necessary help and make whatever reports or disclosures as they deem to be proper and necessary; 
-If a counselee indicates an intention to commit a crime, such intention may be reported and disclosed to the proper authorities; 
-If the counselee is a member of a local church other than CrossPoint and if the pastors of CrossPoint deem it necessary or helpful to communicate information or facts to the pastor of the counselee’s local church they may do so. 
-At any time during the counseling, for reasons sufficient to himself/herself, the counselor – as also the counselee – shall have the option of terminating counseling. 
-If a conflict should arise between the counselee and the counselor, both parties must agree to resolve the dispute outside the secular court system. Conciliation will be sought under submission to and direction of the pastor(s) of CrossPoint Fellowship Church. 



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Basic Summary

 
 
 
 
 
 
 
 
 
 
Personal Data Inventory

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Preferred Scheduling Times (1 Hour Sessions)

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Description

Thank you for filling out this intake form. This will be given to your counselor prior to your first first counseling meeting.