IFs / EFT Counseling Consult Group Form

Name *

First Name

Last Name

Phone

(###)

###

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Group Norms *

To ensure a supportive and productive environment, all participants agree to uphold the following norms (check the box next to each one to signify you agree):

Respect: Speak and listen with kindness and empathy.

Non-judgment: Avoid criticism; offer constructive feedback when invited.

Participation: Engage actively but allow space for others to share.

Time Boundaries: Start and end sessions on me; honor others’ time.

Self-awareness: Monitor your own emotional responses and triggers. Be careful not to dominate the session, taking too much me for details of the case or questions.

Support, Not Therapy: This is a consultative group, not a replacement for supervision (does not count toward Supervision hours for the state).

If you want to present a case or have a question you would like to address, let Holly or Amy know ahead of me so we can plan. If there is extra space in the call, ad hoc cases or questions will be invited.

Confidentiality Agreement *

Confidentiality is essential to building trust. By clicking the boxes below, you agree to:

Keep all shared information private and do not disclose it outside the group.

Do not use the name of your client in the group.

Refrain from recording sessions or taking unauthorized notes.

Notify the facilitator if you believe confidentiality has been breached.

Exceptions to Confidentiality *

Confidentiality may be broken only in cases of (checking the box next to each signifies you understand):

Risk of harm to self or others.

Disclosure of abuse or neglect.

Legal obligations requiring disclosure..