Confidentiality Agreement


To receive services from The Center for Violence-Free Relationships, you will need to accept and abide by The Center’s policies.

The Center for Non-Violent Relationships (“The Center”) is a private non-profit agency dedicated to building healthy relationships, families, and communities free from sexual assault and domestic violence through education, advocacy, and services in western El Dorado County.  The Center offers a wide range of crisis and stabilizing services for victims and survivors for women, men, teens, and children.   It provides emotional support, information, and referral services through its 24×7 crisis line, advocacy, confidential safe house, counseling and case management, support groups, and legal services.

The Center cannot provide legal assistance to both you and to your ex-partner/spouse.

Staff are only able to provide domestic violence or sexual assault services to you through The Center.  As a client, you will not be recruited by staff for any other services.  The Center does not charge clients for basic counseling, although it accepts donations.

INFORMED CONSENT

All services at The Center are offered at will.  You are free to discontinue services at any time.  The nature of counseling at The Center is crisis-oriented in nature and therefore typically short term.  All counseling at The Center is provided by a peer counselor who has met California’s Domestic Violence and Sexual Assault Counselor requirements, but is not a licensed therapist.  The Center for Violence-Free Relationships does not share information with persons or agencies outside of The Center without your written permission.  Anything said to a counselor or staff will be kept confidential with the following exceptions:

  1. Child abuse or neglect.
  2. Danger to yourself, others, or property.
  3. If a Court of Law orders the release of specific information.

Please Note:  Things said in the waiting room are not confidential.  Anything you say in the presence of a third party who is not affiliated with The Center is not confidential nor can The Center guarantee privacy and confidentiality of any digital or electronic communications that occur between the client and the agency.

It is The Center’s desire and intention to preserve the safety of you and your family.  In the event The Center must breach confidentiality, only the most relevant information will be shared. The Center will support you to address any of the above situations to achieve a life safe from violence.

Click here to complete a consent form and provide your signatures to show agreement these policies and terms of service.

The Confidentiality Agreement may also be found here:

https://tinyurl.com/TCCA01