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 Online Counseling: Disclosure (Step 1 of 9)
Service Agreement


Service Agreement

Please read the following statement carefully to understand CCCC procedures. Select 'I Agree' at the bottom to indicate understanding of these provisions.

  1. I understand the agency will provide a confidential comprehensive personal money management interview.

  2. I understand that the interview will be conducted by a certified consumer credit counselor or qualified consumer credit counselor. All plans not conducted by a certified consumer credit counselor will be reviewed by a certified credit counselor.

  3. I understand that if I am dissatisfied, I can utilize the Complaint Resolution Process provided to me on the back of the Client Rights and Responsibilities form provided at this session.

  4. I understand that I will be given a written assessment based on the following options:

    • I may be advised to handle financial concerns on my own.

    • I may choose to enroll in the Debt Management Plan (DMP). Under the DMP the agency serves as a neutral third party in negotiating with creditors to liquidate financial obligations.

      While the agency may obtain a credit report and/or inform any credit-reporting agency of my participation in the repayment plan, the agency has no responsibility or obligation for any past, present, or future credit rating I receive. In certain circumstances, a DMP may affect my credit rating negatively. In the event that the counselor suggests a DMP, I will receive complete details of the operations, requirements, and responsibilities.

    • A counselor may answer questions about bankruptcy, but not give legal advice. If I want legal advice, I will be referred for appropriate assistance. While an attorney can make a recommendation to file bankruptcy, it is a personal choice based on individual circumstances. I will inform the agency of my decision if I file bankruptcy.

    • I may be referred to other services of the organization or another agency or agencies as appropriate that may be able to assist with the problems that have been identified.

  5. I understand that most of the funding comes from voluntary contributions from creditors who participate in the Debt Management Plan (DMP). Since creditors have a financial interest in getting paid, most are willing to make a contribution for help fund our agency. These contributions are usually calculated as a percentage of payments made through the DMP, which can be up to fifteen percent (15%) of each payment received. However, all accounts with creditors will always be credited with one hundred percent (100%) of the amount paid through CCCC. CCCC will work will all creditors regardless of whether they contribute to the agency.

  6. I understand that DMP serves a dual role of helping individuals and families repay debt and helping creditors to receive money owed to them.

  7. I hold the agency, its employees, agents and volunteers harmless from any claim, suit, action or demand of my creditors, myself or any other person resulting from advice or counseling.

  8. At sometime in the future, my information may be used for research and/or a neutral third party may contact me to request a confidential evaluation of the agency's services.

  9. I authorize the employees of Catholic Charities Credit Counseling of La Crosse, to discuss any and all aspects of my financial affairs with whom they deem necessary and obtain a consumer credit report in order to help me solve my financial problems, and agree to hold them harmless from any claim, suit, action, or demand of my creditors, myself or any other person arising out of this agreement. This agreement is effective as of the date below, and continues until the client case file is closed. This consent may be revoked at any time upon written request.

"Nothing herein shall apply to actions or claims under the provisions of the United States Bankruptcy Code, 11 U.S.C. Sec 101 et seq."

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Catholic Charities Credit Counseling
3710 East Avenue South
PO Box 266
La Crosse, WI 54602-0266
888-212-HELP (4357)
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