Finding your path
toward healing,
wholeness & peace.

Crossroads Counseling and Care

Rev. Dr. Haggai Habila, PhD, M.Div, BCC

(253) 220-7790 | (253) 499-8256 | dr.hhabila@gmail.com

General Consent for Counseling Services

Type of Service Requested

Cost of Service

Individual & Couples Sessions: $150 per session. Fees for other services will be agreed upon prior to the first appointment. Payment is due at the time of service.

Cancellation & Refund Policy

⚠️ Cancellation: Sessions must be cancelled at least 24 hours in advance. Failure to do so will result in a $50 cancellation fee.

🚫 No Refunds: No refunds will be issued once a service has been rendered. All fees are final after the session has taken place.

For a Minor Under 13 Years of Age

If this consent is for a child under 13, the parent or legal guardian must complete the fields below.

Consent Statement

I, the undersigned, voluntarily consent to receive counseling and/or care services from Rev. Dr. Haggai Habila at Crossroads Counseling and Care. I have read and agree to the cancellation and refund policies above. I understand sessions are confidential except where disclosure is required by law.

Signature

Crossroads Counseling and Care

Rev. Dr. Haggai Habila, PhD, M.Div, BCC

(253) 220-7790 | (253) 499-8256 | dr.hhabila@gmail.com

Premarital Counseling Consent Agreement

Counseling Period

Cost of Service

The selected package will be confirmed prior to the first appointment. Payment plans may be available upon request. Full payment or agreed installment is due at or before each session. A sliding scale fee may be available for those experiencing financial hardship — please speak with Dr. Habila directly. All inquiries are handled with complete confidentiality and compassion.

Cancellation & Refund Policy

⚠️ Cancellation: Sessions must be cancelled at least 24 hours in advance. Failure to do so will result in a $50 cancellation fee.

🚫 No Refunds: No refunds will be issued once a session has been rendered. All fees are final after the session has taken place.

We, the undersigned, voluntarily consent to participate in premarital counseling with Rev. Dr. Haggai Habila at Crossroads Counseling and Care. We have read and agree to the policies above and understand that all sessions are confidential except where disclosure is required by law.

Crossroads Counseling and Care

Rev. Dr. Haggai Habila, PhD, M.Div, BCC

(253) 220-7790 | (253) 499-8256 | dr.hhabila@gmail.com

Wedding Officiation Service Agreement

Wedding Details

Service Fees

Travel beyond 30 miles from Dr. Habila's base location will incur an additional travel fee, which will be communicated and agreed upon prior to confirming the booking. A non-refundable deposit may be required to secure the date. Full payment is due on or before the day of service.

Reception Attendance

Do you need Rev. Dr. Habila at the reception?

Overtime & Extended Service Policy

Should the ceremony or reception extend beyond the originally agreed hours, the following policy applies: the first 30 minutes of overtime will be complimentary, but any time beyond that will be billed in one-hour increments at the agreed hourly rate. By signing this agreement, both parties acknowledge and accept this policy.

Cancellation & Refund Policy

⚠️ Cancellation: Must be made at least 24 hours before the scheduled service or a $50 cancellation fee will be charged.

🚫 No Refunds: No refunds will be issued once the service has been rendered.

We, the undersigned, agree to the terms of this Wedding Officiation Service Agreement, including all policies regarding overtime, cancellation, and refunds.

Crossroads Counseling and Care

Rev. Dr. Haggai Habila, PhD, M.Div, BCC

(253) 220-7790 | (253) 499-8256 | dr.hhabila@gmail.com

Funeral & Graveside Service Agreement

Family / Contact Information

Service Details

Cost of Service

Payment arrangements must be confirmed at least 48 hours before the service. A sliding scale fee may be available for families experiencing financial hardship — please speak with Dr. Habila directly to discuss available options. All inquiries are handled with complete confidentiality and compassion.

Overtime Policy

Should the service extend beyond the originally agreed hours, the following applies: the first 30 minutes of overtime will be complimentary, but any time beyond that will be billed in one-hour increments at the agreed hourly rate. By signing this agreement, the family representative acknowledges and accepts this policy.

Cancellation & Refund Policy

⚠️ Cancellation: Must be communicated at least 24 hours before the scheduled service or a $50 cancellation fee will apply.

🚫 No Refunds: No refunds will be issued once the service has been rendered.

I, the undersigned family representative, agree to the terms of this Funeral & Graveside Service Agreement, including all policies regarding overtime, cancellation, and refunds. I confirm that I am authorized to make arrangements on behalf of the family.

Signature