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Let Your

Journey Begin

Faithful & True is a place to speak openly, feel freely, and heal with encouragement and support. Whether you're coming as an individual or as a couple, we provide you with a safe place to begin or continue your journey. 

New Client Forms

First, call our office at (952)746-3880 to schedule your initial consult appointment. 

Then, follow the links below to complete and submit our new client forms at least two business days prior to your appointment. 

1. Client Information Form

2. Client Agreement Form

3. Telehealth Consent Form

Forms 1-5

1. Client Information Form

2. Client Agreement Form

3. Telehealth Consent Form

4. Credit Card Form

5. Third Party Payer Release of Information Form

Important Documents

Privacy Policy 

Fee Schedule

General Forms

New Client Information

Client Agreement

Telehealth Informed Consent

Credit Card Authorization 

Third Party Payer Release of Information*

*Only fill out this form if paying with a credit card that does not belong to the client receiving services

1. Client Information Form

2. Client Agreement Form

3. Telehealth Consent Form

Forms 1-5

1. Client Information Form

2. Client Agreement Form

3. Telehealth Consent Form

4. Credit Card Form

5. Third Party Payer Release of Information Form

Important Documents

Privacy Policy Fee Schedule

General Forms

New Client Information

Client Agreement

Telehealth Informed Consent

Credit Card Authorization 

Third Party Payer Release of Information*

​

Only fill out this form if paying with a credit card that does not belong to the client receiving services

Clinician Specific Forms

Couple's Consent

For clients of Russ & Susie Smidt

Coaching Agreement

For clients of Russ Smidt

For clients of Dee Vodicka

For clients of Brittany Gonzalez

Worker Cutting Stones

Under Construction

Thank you for your patience while our website undergoes some necessary updates!

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If you need to submit forms urgently, please call us at 952-746-3880.

Must Read Documents

Our Fee Schedule contains pricing for our counseling services. The Privacy Policy details our commitment to protect your personal information.

Please note that we are not a provider for insurance companies, nor do we submit insurance claims.

General Forms

New clients:

All new clients must fill out forms 1-4 and, if applicable, form 5. 

For questions, please call our office at (952)746-3880.

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Existing or returning clients:

To update your credit card information, call our account manager, Peg, at (952)934-4856.

To update your address or contact information, resubmit form 1 or call our office at (952)746-3880.

Clinician-Specific Forms

Some of our clinicians require extra forms to see. Please fill out all forms for your clinician thoroughly and accurately.

6. Couple's Consent Form

For clients of Russ and Susie Smidt

7. Coaching Agreement

For clients of Russ Smidt

8. Coaching Agreement

For clients of Dee Vodicka

9. Coaching Agreement

For clients of Brittany Gonzalez

Clinician-Specific Forms

Some of our clinicians require extra forms to see. Please fill out all forms for your clinician thoroughly and accurately.

6. Couple's Consent Form

For clients of Russ and Susie Smidt

7. Coaching Agreement

For clients of Russ Smidt

8. Coaching Agreement

For clients of Dee Vodicka

10. Coaching Agreement

For clients of Brittany Gonzalez

New Client Forms

First, call our office at (952)746-3880 to schedule your initial consult appointment. 

Then, follow the links to complete and submit our new client forms at least two business days prior to your appointment. 

Please note that we are not a provider for insurance companies, nor do we submit insurance claims.

  1. New Client Information

  2. Client Agreement

  3. Credit Card Authorization Form

  4. Telehealth Informed Consent

  5. Privacy Policy 

  6. Fee Schedule

  7. ​Couples' Consent Form 
    Russ & Susie Smidt's Clients Only  

  8. Coaching Agreement 
    Russ Smidt's Clients Only 

  9. Coaching Agreement 
    Dee Vodicka's Clients Only 

  10. ​Coaching Agreement 
    Brittany Gonzalez's Clients Only 

I felt Dr. Greg was talking directly to me. Everything he said seemed to apply to my struggle. This has been a life changing experience!

Mauricio L.

Excellent experience! I now understand much better the “why” of my problem. Thank you for allowing me to be led by men (and women) of faith who clearly understand this addiction.

Michael B.

​I finally feel loved! Thank you, Dr. Greg Miller, Debbie Laaser, Beth Miller, Chris Hardesty and others for working through your plan so that I can be free!

Dennis J.

Why Workshops

Workshops help participants to not feel alone, encourages honesty and vulnerability, and gives practical tools, tips, and lessons to help manage addiction and unwanted behavior.

Thanks for submitting!

Contact Us

Interested in one of our workshops or have some lingering questions about your healing journey from pornography & sex addiction?

Contact us today. 

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