Pre-Marital Counseling Application

You will need to fill out the pre-marital application together.

A copy of this application will be emailed to both of you after you submit.

Thank you!

Pastoral Counseling Team

Counseling Contract

I/We affirm the accuracy of the personal information provided herein, have read the information above, and agree to the conditions set forth therein. I hereby agree to the following conditions:

1. I/We understand that the counseling I/we, my family, or those legally under my guardianship will receive will be based upon the Bible, with the goal of glorifying God and leading to grace-filled, godly living.
2. I/We will keep the appointment time or will call prior to 24 hours to cancel with a legitimate excuse. In respect of my counselor’s time and preparation, as well as other counselees who could have had this time slot, if I fail to call 24 hours in advance (unless it is an emergency), I will pray about the amount the Lord would have me donate.
3. I/We will fulfill the weekly assignments or the session might not be held.
4. I/We will consistently attend a Bible-believing, teaching, and practicing church while I/we are in counseling and, preferably, at least one other Bible-teaching study/service during the week.
5. I/We understand that confidentiality is an important part of the counseling process and my counselor is careful to protect confidentiality, desiring to operate under high ethical principles. However, there are times when my counselor must share certain information with others, such as:
   • Counselors, pastors of your church, or the pastor/elders of IMC must be consulted for advice.
   • Information is revealed which indicates a genuine potential for harm to you or to others; counselors may have to share that information with the appropriate authorities or family members, being obligated by conscience and by the laws of this state in regard to counseling relationships, and being required to report to the appropriate authorities any information that raises suspicion of child abuse, intent to harm oneself, and/or intent to harm another person.
   • A person persistently refuses to renounce a particular sin; it may become necessary to seek the assistance of others in the church to encourage repentance and reconciliation (Proverbs 15:22; 24:11; Matthew 18:15–20).
   I understand my counselor(s) strongly prefer not to disclose personal information to others and desire to help me find ways of resolving problems as privately as possible.
6. Due to the litigious society, this counselor has been asked to have a release signed by each counselee as follows: I/We do hereby agree to hold all counselors affiliated with our Pastoral Counseling Services, and its leadership harmless from any advice, counsel, or suggestions rendered during our counseling sessions. We recognize that their role is to assist me/us in hearing and understanding God’s will in the matters we discuss. We will not, therefore, sue or engage in any type of litigation negatively affecting this church, nor their Biblical Counseling Services, or organizations granting them the ability and resources to provide counseling services. Furthermore, I/We agree not to attempt to subpoena or require any counselor to appear in any legal proceeding related to any matters discussed during counseling, nor will I/We attempt to subpoena any notes or records related to this counseling.
7. I/We will purchase any books or materials for homework assignments that my counselor recommends.
8. Unfortunately, Pastoral Counseling Services is unable to provide child care.
9. Our Counseling Services is a faith-based ministry that depends upon generous contributions of its counselees, members, and partners. Additional costs are underwritten by church members.

Counseling & Ceremony Officiant Fees

1. 4 Counseling Sessions: $_______
2. Rehearsal (1 hour): $________
3. Ceremony Officiant (3 hours): $______ (plus $2_____ security deposit)
4. If running late, a $_______ per hour fee is taken from the security deposit for a maximum of 2 hours. If on time, we issue a check refund the same night of the ceremony.
5. If the ceremony is outside of our county, there may be travel and/or lodging expenses for the pastor. Please request an estimate from our Administrative Team here.

Official Booking Requirements

Before counseling, rehearsal, or ceremony is booked, booking fees should be paid here.

Thank you!

If you have any questions about payments or booking, please contact our Administrative Team here.