I appreciate the opportunity to work with you as your coach and am looking forward to our journey together. I’d like you to be familiar with the following policies and procedures. Please read them carefully. If you have questions, please ask.
FEE: My fee is $210705 for a 50-minute coaching session. Payment is expected at the time of service. Please be aware that coaching sessions are not reimbursed by insurance companies.
PURPOSE: The purpose of our time together is determined by the outcome you are seeking. Together, we will look at what your goals are and what obstacles you have encountered as you pursue those goals. We will look in particular at beliefs and behaviors that are ineffective or destructive and are holding you back. I will offer you new ways of thinking about your challenges as well as new behaviors to explore.
SERVICES: In order to understand and clarify the services and relationship, client and coach acknowledge and agree that:
A. Coaching is a relationship which is designed and defined by the client and which is based on the client’s expressed interests, goals, and objectives.
B. The coach will use questions and discussion to help the client identify personal challenges, the impact of these on the client or relationship, and develop strategies to achieve the goals of the client.
C. Coaching is not therapy or counseling.
D. The client is responsible for his or her own achievements and success and the coach cannot and does not promise that the client will take any specific action or attain specific goals.
E. Coaching services are not intended to diagnose or treat mental illness or replace counseling services by a licensed individual within your state or country.
CANCELATION: If you cannot attend an established appointment, please give 24-hour notice.
PROBLEMS: If I say or do something that upsets you or doesn’t feel right, please bring it up in our session. If you are not satisfied with how coaching is proceeding, please discuss it with me and we will collaborate to make necessary adjustments.
DETERMINING FIT: Because I physically reside in Utah, when I coach individuals outside of the state of Utah, coaching sessions are conducted through an internet video connection. Not all potential clients are a good fit for this method of coaching service, as the level of support provided is limited. You and I will determine goodness of fit through initial contact and initial internet meeting and will continually assess fit through the coaching process.
METHOD OF DELIVERY: Coaching sessions are conducted by Zoom teleconference which uses a secure network. Sessions may also take place by phone or in person at my office if preferred.
LOCAL SUPPORT: Since I am your coach and not your therapist and I am not local to you, by working with me, you agree that in the event of a psychological emergency or any emergency, you will actively seek and utilize local mental health support including calling 911 and/or going to your nearest hospital emergency room and/or establishing an ongoing relationship with a local, licensed health professional. Coaching services are not intended to diagnose or treat mental illness or replace counseling services by a licensed individual within your state or country.
CONFIDENTIALITY: The coach may obtain confidential personal and/or business information from the client and agrees to keep and maintain such information confidential and not to disclose or use such information without client’s prior written consent. Generally speaking, information provided by and to a client during sessions is confidential. You should be aware that legal confidentiality does not apply in a criminal or delinquency proceeding. There are other exceptions to confidentiality, such as intent to physically harm oneself or another human being, suspected child abuse, a court order, and some issues related to HIV/AIDS.
LIABILITY: The client understands the sessions are consultative in nature and that any actions and decisions made by the client are solely the responsibility of the client. The coach makes no guarantees, warranties, expressed or implied, about any results to be achieved. This agreement shall be construed under the laws of the state of Utah.
WAIVER: The client acknowledges and agrees that in the course of the services the coach may ask the client questions that may be personal, challenging or disturbing. The client waives and releases any claims arising or resulting from these kinds of questions, actions or services.
If you have any questions or would like additional information, please feel free to ask.