Informed Consent for Relationship Insight 360

This document explains what to expect from Relationship Insight 360 by Guiding Light Health Care Services, LLC. Please read it carefully. You will be asked to review and electronically sign a version of this consent before beginning.

What the assessment is

A 90-minute structured clinical assessment designed to help a licensed clinician understand your relationship and recommend appropriate next steps. It includes separate private questionnaires for each partner, a relationship history review, conflict-pattern analysis, and a written treatment plan.

What the assessment is not

• It is not couples therapy or ongoing counseling.
• It is not a compatibility quiz or a diagnosis engine.
• It is not a crisis or emergency service.
• It does not guarantee any relationship outcome.

Voluntary participation

Participation is voluntary. You may pause, resume, or withdraw at any time. Withdrawal may affect the completeness of your report.

Privacy between partners

Each partner has a separate account and record. Your individual answers — especially safety-screening responses — are not disclosed to the other partner. The final written report is shared only after clinician review and approval.

Safety screening

The assessment includes a strictly private safety screening. High-risk responses may result in discreet guidance, a priority clinical review, and adjusted recommendations (for example, not recommending joint counseling if it would be unsafe).

Limits of confidentiality

Confidentiality is protected by law and by our policies. Legal limits apply in situations involving imminent danger to self or others, suspected abuse of a minor or vulnerable adult, or as otherwise required by law or court order.

Communication

We do not include private responses in email. Notifications reference your secure portal. You may adjust communication preferences at any time.

Consent to sensitive information

By signing, you acknowledge that the assessment includes sensitive topics such as intimacy, conflict, mental-health history, substance use, and safety. You consent to the collection and clinician review of this information for the purpose of assessment and treatment planning.

Questions

If any part of this consent is unclear, please contact GLHCS before signing.