In consideration for permission to participate in voluntary pastoral and spiritual counseling and prayer ministry (hereinafter referred to as “The Ministry”) the undersigned, You, herein referred to as “Counselee”, agrees as follows:

1. Counselor Disclosure & Release of Liability: Intervene International provides Counseling and Prayer Ministry to individuals and to groups. Our counseling is done by pastoral/lay ministers, herein referred to as “Counselors.” These individuals are not licensed as professional counselors, social workers, or psychologists. The Counselors of Freedom Ministries make no implicit or explicit guarantees about their own abilities. This ministry does not claim to meet any counseling requirements for court/probation/parole-mandated counseling. We do not render any financial, legal, or medical opinions and or advice. The Holy Spirit, not the Counselor, is the agent of change—provided the Counselee cooperates with Him. All results are within the power and wisdom of God. It follows then, that the Counselors cannot be held responsible for any results, consequences, or effects or lack thereof, which the Counselee may or may not experience as a result of these sessions.

• Counselee’s Commitment: Your Intervene ministry team will be making a major commitment to you; first as they schedule their time to be available to you, and also as they pray, prepare, and then minister to you. Counselors, as fellow believers, commit themselves to seeking the Lord for your healing, spiritual wholeness, a prophetic word and/or the areas of personal growth the Lord has planned for you. Our sacrifice in this commitment is “time,” a precious and non-replaceable gift. It is given freely in love. In consideration, it is expected that you will be committed to obtaining the maximum benefit possible from your ministry time. You can facilitate this by:
  • a)  Being on time to ministry sessions
  • b)  Completing “homework” assignments given to you
  • c)  Maintaining a sincere desire to overcome whatever problems are hindering you. This means that you will
    cooperate fully with your FTFM ministry team and with the Holy Spirit, through prayer, in order to maximize receiving God’s help in your life.
• Governing Authority: By signing this document you acknowledge and accept that your session/s and the spiritual guidance you receive in them will be based on the Bible, which is the Word of God.
• Referral Policy: If it becomes apparent that secular or psychological counseling may address the Counselee’s needs better, the Counselor may initiate a referral to a licensed professional counselor, social worker or psychologist. The Counselors of Intervene International make no implicit or explicit guarantees about the abilities of the counselors they may refer counselees to.
• Confidentiality Agreement: Under normal circumstances, your Counselor will use their good faith efforts to keep your discussions in confidence. However, Intervene International cannot guarantee complete confidentiality regarding all information received from you.
  By law, there are certain situations in which information about individuals undergoing counseling may be released with or without permission. These situations are as follows:

• a)  Where children are physically abused, neglected, or sexually abused, the proper authorities must be notified.
• b)  In emergencies where there may be danger to the client or others, as with homicide or suicide, confidentiality may be broken.
• c)  If a court law issues a legitimate subpoena relating to a child abuse case, we are required by law to provide the information specifically described by the subpoena.
• d)  If an unreported life-threatening felony has been committed, we are required by law to report it to the police.
• e)  Additionally, if you occupy a leadership or ministry position, your Counselor may also disclose information to the person in authority over you, in the event he or she deems it relevant to your fitness or ability to fulfill your position.
• f)  By signing this agreement, you acknowledge that some officially recognized church staff and lay-personnel may also be given limited access to your personal file should your counselor deem it necessary. Any other person seeking access to your pastoral file may do so only with your written permission.
• g)  To ensure the highest quality counseling process, as a rule-your counselor may consult with their counseling supervisor regarding your session/s. This includes but is not limited to Pastor Brady Duke, the oversight ministry team, and/or their designated representatives, concerning their ministry to you.

• Parental Consent & Commitment to Be Available for Minors Involved in Counseling: Intervene International requires that parents(s) must be actively involved in any Counseling and/or Prayer Ministry that is extended to a minor child as determined by the Counselor. At the discretion of the Counselor, parent(s) may be required to make themselves accountable for active participation in Counseling and/or Prayer Ministry offered by Intervene International.

7. Duration Commitment: Each counselee is given up to three hours of counseling within the initial meeting. It is within the sole discretion of the Counselor to meet for less than three hours in the initial meeting. It is within the discretion of the Counselor to decide whether additional counseling will be necessary or helpful beyond the initial meeting. Counselee is not entitled to more than the initial session.
8. Waiver of Liability: In consideration for receiving any form of counseling from Freedom Ministries, the Counselee agrees to release and waive any and all claims of any kind against the ministry, the staff, the pastoral/lay counselors, which may arise from, result out of, or be related to, conduct or advice given.
9. Dispute Resolution: This agreement and release form, herein referred to as the “Ministry Agreement”, will govern all relations involved during the term of the counseling process. It is agreed that any dispute arising out of or relating to this Ministry Agreement or the services provided by Intervene International will be determined directly between the individuals involved. In the event that a satisfactory resolution is not achieved, then it is further agreed that a mutually acceptable third party mediator will be utilized. If the mediation is unsuccessful, then the dispute shall be submitted to Christian Arbitration under the Rules of Arbitration published by the Institute for Christian Conciliation. All expenses incurred will be the responsibility of the party bringing the dispute. Procedural Rules governing arbitration and mediation can be found at Peacemaker.net/rules-of-procedure
10. Class Action Waiver: By signing this agreement, NO ARBITRATOR OR COURT MAY ORDER, PERMIT OR CERTIFY A CLASS ACTION, REPRESENTATIVE ACTION, PRIVATE ATTORNEY GENERAL LITIGATION OR CONSOLIDATED ARBITRATION IN CONNECTION WITH THIS AGREEMENT TO ARBITRATE OR THIS MINISTRY AGREEMENT AS A WHOLE. BY ACCEPTING THIS ARBITRATION AGREEMENT, YOU AGREE TO WAIVE THE RIGHT TO INITIATE OR PARTICIPATE IN A CLASS ACTION, REPRESENTATIVE ACTION, PRIVATE ATTORNEY GENERAL LITIGATION OR CONSOLIDATED ARBITRATION RELATED TO THIS AGREEMENT.
11. Counselees with any concerns or questions about this agreement agree to raise them with the Counselor prior to signing this document or at the earliest possible time.

By signing this document, I acknowledge that I have read and understand all of the above provisions, including the Waiver of Liability and Confidentiality Agreement and that I accept the stated conditions and limits of liability and confidentiality. I understand my counselor’s commitment to me and I commit to doing my part as it is described in section 2 of this agreement.

By signing this document, I acknowledge that I am agreeing to its’ terms and doing so voluntarily.