Client Agreement and Exclusion of Liabilities
*I understand that Anna Strasburger is not a licensed or clinical social worker, psychologist, physician, psychotherapist, marriage counselor, medical professional, medical doctor, medical provider, psychiatric nurse, nurse, interventionist, child-counselor, clergyman, massage therapist, social worker, Qualified Mental Health Professional as defined by the Virginia Department of Health Professions, counselor, crisis counselor, family-support partner, substance use counselor, addiction counselor, CSAC, mental health therapist, or trauma therapist.
Anna Strasburger is also not qualified to diagnose, perscribe or treat any ailment or condition; rather she will exclusively use a person-centered, peer coaching approach which may or may not aid in addressing concerns. I also understand that if I have any specific physical, mental or emotional problem(s), I should consult a licensed health professional for any prescribed course of treatment.
If you are unclear about anything offered or discussed during your sessions, it is your responsibility to ask for clarification. If you have questions regarding your pharmaceutical prescriptions, mental healthcare or medical advice, please consult with your doctor or therapist. Anna will provide services with reasonable care and skill but we make no other warranty, express or implied, with respect to those services. All other warranties are excluded to the maximum extent permitted by law. In no event will we be liable for any physical or mental injury, or any negative side effects or consequences, that may arise from sessions.
*I also understand though everything said is confidential, being that a Certified Peer Recovery Specialist (CPRS) is a state-mandated reporter, Anna will report any concerns if an individual is at risk to themselves or others; if there is any suspected abuse relating to minors, anyone with diminished capacity, and/or elders; active abuse; or threatened suicide/homicide per law.
I further understand that if the provider feels that anything discussed in sessions is beyond their scope or is inappropriate, they will make a recommendation for appropriate care and provide a resource. I also further understand, that if Anna feels that anything in the sessions has become inappropriate, she has the right to terminate the session and the client may be charged for full the session.
I have read and understood the above and agree with it.
Entering/typing and signing your name in the fields below constitutes signing the document, confirming the signer agrees to the terms and conditions stated.