I acknowledge that Life Center is not a professional counseling organization and that none of the team members are licensed counselors. I understand that these team members are, to the best of their abilities, doing what they can to help me achieve more freedom in my life. I have sought assistance on my own accord and am under no obligation to accept any advice or help I may receive. I understand that if I receive counseling from Life Center, the team is committed to respect the disclosed information, unless these two issues are mentioned: Any intent of a person to take harmful, dangerous, or criminal action against another person or themselves and any act of child or elderly abuse or neglect. I agree to hold Life Center and its team members free from any liability, loss, or damage arising from assistance I have received or my involvement with Life Center. I have read and understand this disclaimer and release of liability and have signed it as my free and voluntary act. Signature: Must be signed by applicant or legal guardian if applicant is a minor (under 18 years of age) by typing your name below.
