DISCLAIMER By registering for services with God’s Word, you are declaring that you understand, agree with and will abide by the services provided. You will not hold God’s Word liable for any decision or action made by you or by those in your care. You attest that you are at least 18 years of age. You attest that if you are suicidal or having suicidal thoughts, you have read the information on our homepage “Contemplating Suicide”. You attest that you are not suicidal nor do you present a danger to others. You attest that you are the authorized user of the credit / debt card you are using or you have the owner’s permission to use the card. You understand that the “Holy Bible” is used as an authoritative source for services. You understand that sharing any information online is not 100% secure. God’s Word will do its best to keep your information secure, with respect of state laws. Confidentiality Regarding Counseling: We keep records of assessments and clinical notes. All information kept is privileged and confidential. Information will only be released to other professionals, individuals or organizations with your written permission. Prior to releasing any information a consent form must be signed by you, authorizing God’s Word to release information. When counseling, the following are exceptions to confidentiality and must be reported: · Evidence of child abuse, abuse of the elderly, the disabled, or the physically and mentally incompetent · Endangerment to yourself or others · If you or your heirs, executors, or administrators file suit or a complaint against God’s Word, any of its volunteers or employees · If ordered by a court to release information · If a claim is filed for your insurance carrier You have the right to have access to your records. You are entitled to receive information about the methods of therapy, the techniques used, the duration of therapy, and the fee structure. If using insurance, you are responsible for payments that your insurance carrier does not cover. You understand that if you have a mental illness, mood or personality disorder, God’s Word online services should not be your only means of treatment. Such disorders and or illnesses require further treatment other than online counseling. If you have a mental illness, mood or personality disorder you must disclose this information to God’s Word. You understand that if you are under the care of a mental health professional you must provide God’s Word with this information. You attest that the services you receive through God’s Word are appropriate for you and do not conflict with any other medical or mental health treatment you may be receiving. Cancellation Policy: Once a course, seminar or counseling session has begun, no cancellations are allowed and a refund will not be given. Registration fees are non-refundable. To cancel a seminar, you must give God's Word a 5 day advance notice. To cancel a course or counseling sessions, you must give God's Word a 24-hour notice or you will be charged for the session and or course. You may be asked to create a Username and a Password. This is to be used for online counseling sessions, courses, or seminars. God’s Word will not keep a record of your password. Once you have registered, for the service you desire, submit payment and we will contact you to begin services. ** Please print and keep a copy of this form for your records. If you have further questions do not hesitate to contact us via this website or call:   (254) 634-WORD (254) 634-9673 Or write us at: God’s Word  104 W. Church Ave  Killeen, TX 76541