2026 Austin Dr., Novi, MI 48377; T-248-385-3498; F-810-213-0555; contact@ConflictResolutionInstitute.com
                                                 Disclosure & Informed Consent Statement

[X] Qualifications [X] Counseling Experience

Experience diagnosing, assessing & treating a wide range of mental health disorders & their effects with individuals, couples, & families, including those related to Anxiety, Depression, Trauma, Psychosis, Compulsions, Impulsivity, Conduct, Attention, Substance Abuse & Addictions of many types.

[X] Counseling Practice

My practice is rooted in the Evidence-Based, Third-Wave, Transdiagnostic, Process-Based and Mindfulness-Based therapy of the Contextual Behavioral Science tradition, Acceptance and Commitment Therapy, whose targets are the components of the Psychological Flexibility Model.
We approach Mental Health wholistically and are open to dialogue/work with clients on Mental and Emotional Health, Physical Exercise and Activities Health, Nutritional & Metabolic Health and Spiritual Health.

[X] Diagnosis: If the client seeks Health Insurance reimbursement, a mental-health disorder diagnosis will be necessary. Diagnoses become part of the client’s permanent insurance records.

[X] Confidentiality: Communications are confidential with the following exceptions:

[X] Voluntary Treatment: The client has the right to terminate treatment without cause. CRI has the right to refer client(s) to a more suitable counselor when deemed necessary.

[X] Complaints: A client may file a complaint with the Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing, Investigations & Inspections Division, P.O. Box 30670, Lansing, MI 48909, (517) 241-0205.

[X] Results & Risks: The client recognizes the change process involves changing one’s self concept, perspective, behaviors and relationships. CRI does not force or recommend changes, rather talks to the client about options and uses evidence-based techniques to help. CRI does not guarantee results. The client does not hold CRI responsible for its efforts to assist the client with his/her problem.

[  ] SMS Appointment Reminders

By providing my mobile number and checking the box below, I agree to receive automated SMS appointment reminders from Conflict Resolution Institute (CRI). These messages contain only the date, time, and location of a scheduled appointment and a way to confirm, cancel, or reschedule. Consent is voluntary and is not a condition of receiving services. Message frequency varies. Message and data rates may apply. Reply STOP to opt out at any time, or HELP for help. Your mobile information will not be sold or shared with third parties for promotional or marketing purposes.
   
 Yes, I consent to receive SMS appointment reminders


Upon opt-in, the client receives a one-time confirmation text: “CRI: You’re subscribed to appointment reminders. Msg frequency varies. Msg & data rates may apply. Reply HELP for help, STOP to opt out.” For help, reply HELP or contact CRI at 248-385-3498. To opt out at any time, reply STOP.

Acceptance of Terms: We agree to these terms and will abide by these guidelines.

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