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I agree that if I am having a rough time and come to a point where I may break any of these promises I will call and make significant contact with any of the following individuals Patrice Cox LPC 404 936-3126 Cell Or if I cannot contact these individuals I will immediately call the Suicide Crisis Hotline at 1-800-SUICIDE 1-800-784-2433 / 1-800-273-TALK 1-800-273-8255 OR 911 I agree that these conditions are important worth doing and that this is a contract I am willing to make and keep. By my word and honor I intend to keep this contract. NO-HARM CONTRACT I agree to not harm myself or others in any way attempt to kill myself or others during the duration of counseling services. I agree that for any reason if the appointed session is postponed canceled etc* that this time period is extended until the next direct meeting with my counselor. In this period I agree to care for myself to eat well and to get enough sleep each night. I agree to make social/family contact with the following individuals I agree to rid my presence of all things I could use to harm or kill myself and others. I agree that for any reason if the appointed session is postponed canceled etc* that this time period is extended until the next direct meeting with my counselor. In this period I agree to care for myself to eat well and to get enough sleep each night. I agree to make social/family contact with the following individuals I agree to rid my presence of all things I could use to harm or kill myself and others.

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