Consent for Counseling Minors

Anonymous's picture

By signing the following document electronically, it is to be the legally binding equivalent of your individual handwritten signature. 

This is to certify that I give permission to Restore Counseling Center for the treatment of my adolescent/child. 

This counseling may include individual or group psychotherapy, counseling, and testing.  This counseling may include consultations with other associates, including Intern’s supervisor(s).

This counseling may also include referrals to other appropriate State and County or professional agencies for further counseling or testing. 


If you are a licensed counselor, a counselor intern or interested in individual or group supervision and would like to join our team, please contact us.

Meredith Akin-Ivey, is a Licensed Professional Counselor-Supervisor and a Registered Play Therapist- Supervisor.  Please E-mail or call her for more details.

Follow Us On:

Get in touch

Compassion Counseling
2214 Michigan Ave
Suite F
Arlington, Texas

Phone: (817) 723-1210

Fax: (866) 776-5116

Our Specialities

At Compassion, our counselors have experience counseling a variety of issues including but not limited to: adoption, anxiety, abuse, body image, depression, couples, faith, families, grief, play therapy, parenting, teens, trauma, christian sex therapy, and self-esteem. Please call our office for more information regarding each counselor's specialty.