info@thelisteningearcms.com, 615-767-3564 2245 Rosa L. Parks Blvd., P.O. Box 280298 Nashville, TN 37228-9998

THE LISTENING EAR (CMS) COUNSELING AND MEDIATION SERVICES DISCLAIMER AND RELEASE OF LIABILITY AGREEMENT

PLEASE READ CAREFULLY

Required Waiver and Release of Liability MUST BE READ AND ACKNOWLEDGED at the time of an initial counseling or mediation session with The Listening Ear.

You, as the user, agree that using any or every part of this service is entirely at your discretion. The Listening Ear Counseling and Mediation Services are provided without warranty of any kind, either expressed or implied, including without limitation, any warranty for information, services, or products provided through or in connection with The Listening Ear.

CONFIDENTIALITY

The Listening Ear CMS is very sensitive to the issue of confidentiality. Confidentiality is crucial to an effective and trusting counseling or mediation relationship. The Bible repeatedly warns against gossip and indicates that trustworthy persons keep confidence. To release any information without your consent would violate both commonly accepted codes of ethics and biblical standards.

There are three situations, however, where it may be necessary to share certain information with others.

By signing this Agreement, you authorize the counselor or mediator to share information with others in the following circumstances:

1. When there is a clear indication that you may harm yourself or someone else.
Adult and Domestic Abuse: If there is reasonable cause to believe that an adult is in need of protective services (regarding abuse, neglect, exploitation, or abandonment), the MANDATORY REPORTING LAW REQUIRES such actions to be reported to the local agency that provides protective services.

2. Serious Threat to Health or Safety: If you express a serious threat, or intent to kill or seriously injure an identified or readily identifiable person or group of people, and it is determined that you are likely to carry out the threat, reasonable measures will be taken to prevent harm. Reasonable measures may include directly advising the potential victim of the threat or intent.