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Danny Wade
Dinah Wade
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Information Disclosure and Consent Statement  
It is my pleasure to serve you as you seek counseling assistance. This packet contains information you may need to refer to during our counseling relationship. If you have questions about the policies of Grace Counseling Center, please do not hesitate to ask me.  

GENERAL INFORMATION
 
I use an approach to counseling which takes into account your spiritual, emotional, physical and social dimensions.  One of your primary tasks will be to determine your goals for counseling.  These goals may evolve as we work together.  Whatever your goals, my hope for you is that you grow and mature, reaching a point at which you are able to resolve your problems or develop alternatives for living with these problems.  It is, however, impossible to guarantee any specific results.   I work primarily with adults and adolescents.  I offer individual, marital, family and group therapies.  I work commonly with men and women with the following kinds of issues: depression, marital struggles, recovery from past childhood abuse, sexual abuse, anxiety, anger, and compulsions.  I will address your individual issues in the context of encouraging your spiritual growth. I have a growing interest and training in the Enneagram.

QUALIFICATIONS
 
I am a Licensed Professional Counselor (LPC) with the state of Texas (license # 14632).  I assure you that my services will be rendered in a professional manner consistent with accepted ethical standards as established by the Texas State Board of Examiners of Licensed Professional Counselors.

I completed my undergraduate studies at Oklahoma State University with a Bachelor of Arts degree in English after having attended three colleges in three different states. As the wife of an Air Force Pilot, we lived in several states around the country. During those years, I taught English to high school students, volunteered with various organizations, and had two children. My husband retired from the Air Force and both of us attended Colorado Christian University, completing a Master of Arts degree in Biblical Counseling under the direction of Dr. Larry Crabb and Dr. Dan Allender. I have maintained a counseling practice since 1996 in the San Antonio are, and we opened Grace Counseling Center in 2000 in Boerne. I have been associated with various evangelical churches.

CONFIDENTIALITY
 
I will keep absolutely confidential anything you say to me with certain exceptions.  These are: (a) you direct me to tell someone else; (b) I determine you are a danger to yourself or to someone else; (c) a court orders me to disclose certain information; or (d) child abuse is taking place.  In this final case, I am required by law to disclose this information to Texas Child Protective Services.        

FINANCIAL POLICIES AND INSURANCE PROCEDURES
 
Counseling sessions will be generally 50 minutes in length unless otherwise arranged.  I meet with most of my clients on a weekly basis.  Occasionally, I meet more or less frequently, depending on the client’s need.  I require full payment for counseling at the scheduled appointment in most cases.  Please make your payment at the conclusion of each session unless other arrangements are made.  If you pay by check, please try to fill out your check ahead of time.  I also accept Master Card or Visa.  

CANCELLATION POLICY:
 
In the event that you will not be able to keep a scheduled appointment, please notify my office at least 24 hours in advance of your appointment.  If I do not receive such advance notice, you will be responsible for paying the full fee for the session you missed.  If another party supplements your counseling fees, you will be responsible for paying the fee rather than that party.  Please be advised that two consecutive missed sessions without notice or extenuating circumstances may constitute a termination of our therapeutic relationship.   If you wish to seek full or partial reimbursement for my services from your health insurance company, I will be happy to provide all the necessary information your insurance company requires for submitting your claim.  Please advise me of your intentions to file your claim and I will mail invoices to you on a monthly basis.  If I am in your mental health network, I will ask you to complete a form to obtain your insurance information, and file your claims in our office.  Health insurance companies require that I diagnose and disclose your mental health condition to them in accordance with Diagnostic and Statistical Manual (DSM-IV) standards of diagnosis.  Any diagnosis made will become part of your permanent insurance records.  Please speak with me regarding any specific questions concerning these procedures.  

ADDITIONAL INFORMATION
 
The process of helping you address troubling areas of your life is unique in that it inevitably is the catalyst for one or more personal issues to arise that may cause some degree of personal distress.  The fact that this happens is a normal and natural part of the counseling process.  It is my privilege, as the one you have chosen to be involved in this process, to help you work through these problems.  To this end, I anticipate and desire a good and productive professional relationship with you.  The relationship we establish and maintain will be characterized by mutual respect and openness.  However, in the event that a particular dissatisfaction with my services should arise, I will be very willing to discuss the nature of your dissatisfaction and make a concerted effort to move toward a reasonable solution.  If for some reason we are unable to arrive at an acceptable solution, I will be willing to provide you with several possible alternative referral sources.  However, should you believe it necessary to make a formal complaint regarding your counseling experience, you may contact the Texas State Board of Examiners of Licensed Professional Counselors in Austin, Texas at the following:  
1100 West 49th Street Austin, TX 78756-3183 (512) 834-6658  

EMERGENCIES 
As my client, I ask you to agree to the following guidelines regarding emergencies.  In the event of a crisis that you feel you are unable to handle alone, please do the following in the specified order:  
1. Contact a family member for assistance.  If you are unable to resolve the crisis and/or contact a family member, you will:  
2. Contact me at 830-249-9977 if it is during normal business hours, leaving a clear message that you have an emergency.  If you cannot contact me, you will: 
3. Either call Laurel Ridge Hospital at (210) 491-9400 for assistance or present yourself in person at 17720 Corporate Woods Drive, San Antonio, Texas.  If you do none of the above, you will: 
4. Call “911” for emergency assistance.  

If you have any questions about the information contained herein, or about the counseling process in general, please feel free to ask me.