Participant Disclaimer

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By agreeing to participate in the Colorado Agricultural Addiction and Mental Health Program (“Program”), you are entering into this Agreement between you and the Colorado Farm Bureau Foundation (“CFBF”). You should read this agreement carefully, and if you do not agree to be bound by any term of this agreement, you must not participate in the Program.

Upon agreeing to participate in the Program, CFBF will issue six vouchers to you that you may use in exchange for mental health counseling services, which will be provided confidentially by a Counselor of your choice from CFBF’s list of authorized Counselors (“Counseling Services”). Each voucher can be used in exchange for one hour of Counseling Services. Vouchers expire one year after the date of issuance to you; however, you may request that some or all unused expired vouchers be reissued to you as new vouchers by contacting the Program administrator. The Program administrator will have the discretion to reissue expired vouchers.

The authorized Counselors are independent providers who are not CFBF employees, agents, or representatives. The Program is limited to providing payment for the Counseling Services, while the Counseling Services themselves are the responsibility of the Program-authorized counselor (“Counselor”) who provides them. If you feel the Counseling Services provided by the Counselor do not fit your needs or expectations, you may change to a different Program-authorized Counselor. We require every Counselor to uphold ethical standards and maintain the necessary and applicable licenses and certifications of their profession.

IF YOU ARE CONTEMPLATING SUICIDE; OR IF YOU ARE CONSIDERING HARMING YOURSELF OR OTHERS; OR IF YOU FEEL THAT ANY OTHER PERSON MAY BE IN ANY DANGER; OR IF YOU HAVE ANY MEDICAL EMERGENCY, YOU MUST IMMEDIATELY CALL THE EMERGENCY SERVICE NUMBER (911) AND NOTIFY THE RELEVANT AUTHORITIES. SEEK IMMEDIATE ASSISTANCE. THE PROGRAM IS NOT DESIGNED FOR USE IN ANY OF THE AFOREMENTIONED CASES.

While we intend for these Counseling Services to be beneficial to you, you understand, agree, and acknowledge that these services may not be the appropriate solution for everyone’s needs and that these services may not be appropriate for every particular situation and/or may not provide complete mental health treatment in every particular situation. After you have used all six of your vouchers, at your own expense you may continue the counseling with your Counselor or obtain mental health treatment services outside of the Program. However, CFBF will not be responsible for paying for or otherwise supporting these additional services in any way. Counselors are not required to continue providing services to you after you have exhausted the use of your six vouchers. Counselors, Medicare, and Medicaid (Health First Colorado) are not responsible for payment for Counseling Services provided through the Program.

Protecting and safeguarding your personal information is extremely important to CFBF and the participating Counselors. Individuals obtaining and using Program vouchers will not be personally identified by CFBF. Counselors are required to maintain client information in strict confidence and are not permitted to share the participant's personally identifiable information with CFBF.  

You hereby confirm that you are legally able to consent to receive Counseling Services or have the consent of a parent or guardian and that you are legally able to enter into a contract.

You hereby release and agree to hold CFBF and its affiliates harmless from any and all causes of action and claims of any nature resulting from the Counseling Services, including (without limitation) any act, omission, opinion, response, advice, suggestion, information and/or service of any Counselor. You understand, agree, and acknowledge that CFBF and its affiliates shall not be liable to you or any third party for any indirect, incidental, consequential, special, punitive, or exemplary damages. If the applicable law does not allow the limitation of liability as set forth above, the limitation will be deemed modified solely to the extent necessary to comply with applicable law. This section shall survive the termination or expiration of this agreement.

A list of the Program’s authorized Counselors will be made available to you and may change at any time for any reason without notice to you.  A voucher may only be used with currently authorized Counselors and will not be valid for Counseling Services provided by any Counselor that is no longer authorized. In addition, CFBF may modify, suspend, disrupt, or discontinue the use of any unused vouchers at any time with or without notice to you. You agree and acknowledge that we will not be liable for any of the aforementioned actions or for any losses or damages that are caused by any of the aforementioned actions.

By participating in the program, I agree that I have read this agreement carefully, understand its terms, and agree to be a participant in the Program.