I , (We) are voluntarily seeking outpatient counseling, or life skills through 2love1, L.L.C. and it’s contractors, facilitators, educators, teachers, or paraprofessionals.   I, (We) understand that the 2ove1, LLC services consists of training pertaining to ideals and beliefs by the class facilitators, paraprofessionals, teachers and translators and any contracted employees or volunteers and the curriculum used.

I, (We) acknowledge and understand that we are not participating in psychiatric or psychological counseling.  In addition, we understand and recognize that the training facilitators, teachers and translators, contracted employees and/or volunteers are not acting in the capacity of licensed health providers or counselors, except if substance abuse counselor services are being provided or counseling sessions are being provided by a licensed professional in these areas. 

I, (We) acknowledge that any advice shared by the training facilitators regarding individual, marriage, relationship or parenting issues is not given in a professional capacity but is offered solely in their recognized capacity as the training facilitators, teachers or translators, or mentors or para-professionals.

I, (We) understand the class facilitators’ role to be that of teachers/facilitators/mentors.  We understand that the information discussed during the training is confidential.  We agree that when necessary, class facilitators can share pertinent information with the appropriate professionals, such as in the case of domestic violence/child abuse, self-harm or harm to any other individual or if written consent is given to do so by you (the individual receiving services).  We understand that the class facilitators will also treat information in a confidential manner.  Information obtained from minors is not generally shared with parents without permission.

EXCEPTIONS TO CONFIDENTIALITY: Federal regulations do not protect from disclosure of information related to a client’s involvement in a crime against property or personnel. We are required under state law to report suspected abuse of a child, elderly person, or individual with a disability, or any reported sexual misconduct.  We may share limited information in the event of a medical emergency or in the event of a specialized court order signed by a judge.  2love1, LLC and its paraprofessionals, educators, contractors, teachers has the option of breeching confidentiality if you report a specific plan or intent to cause serious bodily harm to an identifiable person. 

I, (we) understand, that any information I, (we) openly share in class is of my own accord and do not hold 2ove1, LLC or facilitator, mentor, teacher, counselor accountable for how that information is shared.

We understand domestic violence is a pattern of abusive behaviors designed to secure control over an intimate partner. 2ove1, LLC has a Domestic Violence Protocol.  We are aware that 2ove1, LLC has a Domestic Violence Protocol.

We consent to the terms as outlined and understand that our participation in this training is voluntary and we waive any and all liabilities against 2ove1, LLC and its facilitators, teachers and translators and substance abuse counselor (if applicable).

Limited Liability: In no event shall the company be liable for any incidental, special, consequential or indirect damages arising out of or relating to the use or inability to use the services, or the results obtained from using the services, including without limitation, lost profits, damages for loss or corruption of data or programs, service interruptions and procurement of substitute services, even if the company knows or has been advised of the possibility of such damages,  Under no circumstance will the company’s aggregate liability, on any form of action whatsoever in connection with this agreement.

In no event shall 2love1, LLC be liable for any damage whatsoever, whether direct, indirect, general, special, compensatory, consequential, and/or incidental, arising out of or relating to the conduct of you or anyone else in connection with the use of these services, including without limitation, bodily injury or damage to property,  emotional distress, and/or any other damages resulting from communications or meeting with other users of this service.

It is very important that you keep your scheduled appointment with us and arrive/be on time.  As a courtesy and to help you to remember your scheduled appointments, 2ove1, LLC sends text messages and reminders of the appointment time.  If your schedule changes and you cannot keep your appointment, please contact us so we may reschedule you, and accommodate those who are waiting for an appointment.  As a courtesy to our office as well as to those clients who are waiting to schedule, please give us at least 24 hour notice.  If you do not call or text to reschedule your appointment, we may assess a $35 no show service charge,  after two (2) consecutive no call no show missed appointments and this fee is not reimbursable.  After 3 consecutive “no shows”, 2ove1, LLC may terminate our services with you.  Your signature below affirms the ”no call” policy of 2ove1, LLC and you understand that you must cancel or reschedule your appointment  at least 24 hours in advance or in the case of emergency to avoid a potential charge to the credit card provided, if on file

I/we hereby consent to 2ove1, LLC recording of my child/grand-child, image and voice during participation in sessions through Zoom or another virtual platform or in person, as well as any personally identifiable information my child may share during instructional activities.  I am the parent or legal guardian of the child’s named below, and hereby fully release and discharge 2ove1, LLC staff and independent contractors from any and all debts or liabilities arising out of or in connection with the above-described uses of my child’s name, image or voice, or personally identifiable information shared by my child during instructional activities.