Heart Renewal Ministries

Agreement for Services

We are entering together into a spiritual direction or spiritual formation coaching relationship. Both spiritual direction and spiritual formation coaching are distinct from other helping relationships, such as psychotherapy, pastoral counseling, mentoring, or discipleship. Problem-solving or resolution of personal psychological issues are not the focus. Although there may be times when discussion of psychological and relational issues are addressed insofar as they affect your relationship with God, the latter is primarily the focus of our relationship together. I may refer you to another spiritual director, life coach, or other professional at any time at your request or in the event that I believe another helping ministry would better serve you.

I affirm that I am a member of ESDA and I ascribe to their “Code of Ethics.” If you would like more information on both ESDA and their Code of Ethics, please go to https://www.graftedlife.org/spiritual-direction/esda/code-of-ethics.

I set the fees for my spiritual direction and spiritual formation coaching services at $60 per session for individuals and $30 per session for group spiritual direction. A free consultation for spiritual direction and spirtual formation coaching is offered. Retreat fees will be decided in consultation with the person(s) contracting for this service, including the number of retreat participants and cost set by a specific retreat center. Workshop fees will be decided in consultation with the party contracting for this service, including the cost, if any, of the workshop venue.

I will maintain confidentiality regarding any content that is shared during our spiritual direction or spiritual formation coaching sessions, including your identity. Aspects of content shared during our spiritual direction or spiritual formation coaching sessions may be shared by me solely for the purposes of supervision and/or consultation. I will not, however, reveal your identity, and any consulting spiritual directors/supervisors will ascribe to similar ESDA ethical guidelines. Information regarding the risk of serious harm to you or another person(s) may necessitate emergency intervention on my part, and at such times I may initiate a change in this confidentiality agreement with your knowledge.

Either one of us is free to terminate our spiritual direction or spiritual formation coaching relationship at our own discretion. We simply need to inform one another of our desire to do so and, if possible, have a final meeting.

If you have any questions about this agreement, please feel free to ask me at any time.

Sincerely,
Roger Parks, Psy.D. 

If you want to sign this agreement through the website, complete the form below and it will be emailed to Roger Parks.

If you prefer to print the agreement and mail it, tap the button below and you can download the file, sign it and mail it.

The tab below will take you to PayPal to pay for your session. You can pay with a PayPal account or choose a credit card. This is a one- time payment.

Attendee Name