Thank you for taking the time to fill out this form.
In signing below I acknowledge that the information I have provided is true and correct to the best of my knowledge at the date signed.
Further,
I acknowledge that I have been provided with a Logan Counselling Services brochure detailing consent and rights/responsibilities of undertaking counselling,
(downlod your copy of the brochure here) I also acknowledge that it is my responsibility to read the aforementioned document and if I am unsure of any of the information I will ask for clarification from Logan Counselling Services staff.