Sign your consent form

1. Client details

Your details are taken from the form below.

In this form, "Good Passion Care", "the practice", "we" and "us" mean Good Passion Care, and any counsellor, coach, facilitator, employee or agent working for the practice. "You" and "the client" mean the person signing below.

2. Nature and limits of the service

By accepting this form, I confirm that I have read and understood each statement below.

• Good Passion Care provides relationship, marriage, family and individual counselling, mental health coaching, community training, and group relationship programmes.
• The service is not medical, psychiatric, psychological diagnosis, legal, financial or religious-authority advice. Nothing said in a session should be treated as such advice.
• Mental health coaching provided by Good Passion Care is coaching and mentoring, not clinical treatment.
• Counselling is not an emergency or crisis service. If I am in danger, or someone else is, I will contact emergency services, a hospital or the police, not the practice.
• I will tell the counsellor about any medical or psychiatric condition, medication, history of self-harm, violence, abuse or substance use that may affect my safety or the counselling.
• The practice may decline, pause, end or refer my counselling if my needs fall outside its scope, if there are safety concerns, or if professional boundaries cannot be kept.
• Good Passion Care is led by committed professional health practitioners of the Christian faith. Faith-based elements such as prayer or Scripture are used only if I ask for them or agree to them.
• For online sessions, I am responsible for my device, internet connection and a private, safe space. The practice is not responsible for interruptions or for anyone overhearing on my side.
• Sessions are not recorded by the practice unless this is agreed in writing, or agreed to in the recorded session audibly. I will not record any session without the written consent of the counsellor and every other participant.
• I have read the practice's Terms & Conditions on payment, cancellation (at least 24 hours' notice) and punctuality, and I accept them.

3. Risks, results and my own decisions

I understand and accept that:

1. Counselling can bring up painful memories and strong emotions. I may feel worse for a time before I feel better.
2. Counselling may lead to changes in my relationships, including conflict, separation, divorce, or changes in family arrangements. These outcomes can happen whether or not counselling succeeds.
3. Good Passion Care makes no promise or guarantee of any result, including saving a marriage or relationship, reconciliation, or any change in another person's behaviour.
4. All decisions I make during or after counselling, about my relationships, family, children, finances, health, employment, faith, legal matters or anything else, are my own free choice and my own responsibility.
5. Assessments and screening tools (such as PREPARE/ENRICH) support the counsellor's judgement. They are not a diagnosis and do not predict the future.
6. I take part voluntarily and may stop counselling at any time, subject to the payment and cancellation terms.

4. Confidentiality and its limits

What I share in counselling is kept confidential, as set out in the Good Passion Care Privacy Policy, which I have been given and have read. Confidentiality is not absolute. Information may be disclosed without my further consent where:

• there is a serious risk of harm to me or to another person;
• a child or vulnerable adult may be at risk of abuse or neglect;
• disclosure is required by law, a court order or a competent authority;
• the counsellor seeks professional supervision or consultation, with identifying details protected; or
• disclosure is needed for the practice to defend itself in a complaint, claim or legal proceeding brought against it.

Couples and families. Information one partner shares privately will not automatically be passed to the other. However, the counsellor will not keep secrets that materially undermine the joint counselling, and may require that such information be shared or that joint counselling be paused.

Groups. Confidentiality cannot be guaranteed in a group. I agree not to disclose anything another participant shares.

Legal proceedings. I agree not to call any Good Passion Care counsellor or coach as a witness, or to request counselling notes or reports, in any divorce, custody, family or other legal proceedings, except where the law requires it. Any report the practice agrees to prepare is charged separately.

5. Waiver, release and limitation of liability

I have been told that Good Passion Care does not hold professional indemnity or public liability insurance, because Good Passion Care is not aware of such cover being made available for counsellors in Mozambique. I accept the service on that basis.

1. Assumption of risk. I freely accept the risks described in Section 3, including emotional distress and changes in my relationships, family or personal circumstances.
2. Release. To the fullest extent permitted by law, I release Good Passion Care from all claims, demands and legal actions arising from counselling, coaching, assessment, group programmes, advice, referrals or communications. This includes claims for emotional distress, relationship breakdown, separation or divorce, loss of income, and decisions I or others make. This release binds me, my heirs and anyone claiming through me.
3. No claim for outcomes. I will not bring any claim based on the result of counselling, or on any decision made by me, my partner or my family members or community members.
4. Indemnity. I will compensate Good Passion Care for any loss, damages or legal costs it suffers because of a claim brought by my partner, family member, community member, or any other person that arises from my participation, my breach of this form, or information I gave that was false or incomplete.
5. Limit of liability. If, despite this form, Good Passion Care is found liable to me, its total liability is limited to the fees I paid for the sessions in question. The practice is not liable for indirect or consequential losses.
6. What this does not exclude. Nothing in this form excludes or limits liability for wilful misconduct (dolo), gross negligence, or anything else that Mozambican law, or the law of my country of residence, does not allow to be excluded. Those parts only are excluded from this section; the rest still applies.
7. Third-party platforms. The practice is not responsible for failures, data breaches or interruptions caused by Google Chat, Zoom, WhatsApp, email providers, payment providers or assessment platforms.

6. Complaints, disputes and governing law

1. Complaints first. If I am unhappy with any part of the service, I will raise it in writing with the Good Passion Care staff at talk@goodpassioncare.online. The practice will respond within 14 days.
2. Mediation. If the complaint is not resolved within 30 days, both sides will try in good faith to settle it through mediation in Maputo, before starting any court or arbitration proceedings. Mediation costs are shared equally unless agreed otherwise.
3. Governing law and courts. This form, and any dispute about the services, is governed by the laws of the Republic of Mozambique. The courts of Maputo City have jurisdiction, unless the law of my country of residence gives me a right that cannot be waived.
4. Time limit. As far as the law permits, any claim must be notified in writing within 6 months of the session it relates to.
5. Severability. If any part of this form is found invalid or unenforceable, only that part is removed or reduced to the extent needed. The rest stays in force.
6. Whole agreement. This form should be read together with the Good Passion Care Terms & Conditions and Privacy Policy. If they conflict on liability, this form applies.
7. Language. If this form is signed in both English and Portuguese, both versions have equal standing.

7. Declaration and signatures

By signing, I confirm that:

• I am 18 or older, or my parent or legal guardian signs below for me.
• I have read this whole form, the Terms & Conditions and the Privacy Policy, in a language I understand.
• I had the chance to ask questions and to take independent legal advice before signing.
• I am signing freely and am not under the influence of alcohol or drugs.
• I understand this form limits my right to sue Good Passion Care.
• This form applies to all future sessions unless I am given an updated version.

Online booking. Where this form is accepted online, clicking "I have read and agree" before booking, or typing my full name, has the same effect as a handwritten signature. The practice will keep a record of the date, time and email address used and will send me a copy.