Confidentiality Form

We’ll briefly go over this form during our intake session.

Feel free to look over prior or save to fill out if you have questions.

Agreement with:

Enter Name of Spiritual Director

Spiritual direction is a ministry that intends to help others discern and respond to the work of Christ in their lives for the purpose of spiritual growth and healing. While, at times, I may discuss psychological and relational difficulties, spiritual direction is distinct from other helping professions, such as psychotherapy, pastoral counseling or analysis. Spiritual direction is also not financial advice and any decisions and actions you may take in that regard are done without my advice or recommendation, and are purely your responsibility. I may refer you at any time at your request, or in the event that I feel that another would better serve you. I affirm that I am a member of Christ-Centered Spiritual Directors Association (CSDA) and I subscribe to their “Guidelines for Ethical Conduct.” While we are meeting, I am acting as your spiritual director, I am not acting as an employee, agent or representative of any church or non-profit organization where we may meet. I agree to maintain confidentiality regarding the content shared during the direction sessions, including your identity. I may share aspects of the content shared during your direction session with other spiritual directors for the purposes of supervision and consultation. Your identity, however, will not be revealed and these directors subscribe to the same ethical guidelines as I do. Emergency situations involving the risk of serious harm to you or another may necessitate intervention, and at such times I may institute a change in this confidentiality agreement with your knowledge. Please sign and return a copy of this agreement to me.

I set the fees for my services and the current per session rate agreed upon with this directee is

$

Name

First Name

Last Name

Date Signed

MM

DD

YYYY