Virtual Counseling Confidentiality Agreement
Virtual Counseling Confidentiality Agreement Form
Submit this Form for Virtual Counseling
East Texas Crisis Center
Monday – Friday
8:30 am – 5:30 pm
P.O. Box 7060
Tyler, TX 75711
Phone: (903) 509-2526
Fax: (903) 509-2283
No Reply: firstname.lastname@example.org
We welcome walk-in crisis intervention and advocacy services during regular office hours, Monday to Friday.
Please refer to the hours of operation for each county of service below. No appointment is necessary.
Thank you for considering our services. We’re here to help.
At our organization, we prioritize the safety and well-being of our clients. That’s why we follow CDC guidelines to provide our services to survivors and victims of family violence, dating violence, and sexual assault.
In addition to our hotline, we offer a chat session with an advocate between 8:30 am and 5:30 pm. To use this service, you will need to agree to our confidentiality agreement. Once you submit your agreement, we will provide you with a HIPAA compliant platform to continue.
You’re not alone.
We’re here to help when you’re ready.
24-Hour Crisis Hotline