Client Name:_____________________________
Address:_________________________________________________________________________
Email: ___________________________________ Day Phone:______________________________ Evening Phone: __________________________ Cell Phone: ______________________________
Date Of Birth: ___/___/___
Session Time and Fees for nutritional coaching: Duration of sessions: up to 60 minutes; two times per month for 6 months @ $1260 payable at the beginning of our work together. This works out to $105.00 per session. See the section under 'basic shared agreements' below for additional information. Feel free to ask me in person about other payment options and/or other coaching plans as I will …show more content…
I certainly understand that emergencies do arise and will accommodate those on a case-by-case basis. Since this is based on a package of 12 visits, a now show visit will reduce the total number of visits by one for each no show offense.
Should you “no-show” for two appointments during our coaching relationship (without notification or rescheduling) we will evaluate whether or not coaching is appropriate for you right now.
If you’ve purchased a package and find yourself unable to use your sessions for any reason, you may put the remaining sessions on a 3-month hold. Session credits will not be carried out further than 3-months. Coaching fees are nonrefundable should you decide to “quit” the process, as our complimentary session is designed to remove the possibility that we would not be a good fit for each other.
You may also email me anytime meihle@gmail.com and I will respond within forty-eight hours excluding weekends and holidays (or when I am away). You may also call me (maximum of twice between sessions) and calls under 7 minutes will are covered as part of the package cost (my number is …show more content…
I understand that “coaching” is a Professional-Client relationship I have with my coach that is designed to facilitate the creation/development of personal, professional or business goals and to develop and carry out a strategy/plan for achieving those goals.
3. I understand that coaching is a comprehensive process that may involve all areas of my life, including work, finances, health, nutrition, relationships, education and recreation. I acknowledge that deciding how to handle these issues, and implementing my choices is exclusively my responsibility.
4. I understand that coaching does not involve the diagnosis or treatment of mental disorders as defined by the American Psychiatric Association. I understand that coaching is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment and I will not use it in place of any form of diagnosis, treatment or therapy.
5. I promise that if I am currently in therapy or otherwise under the care of a mental health professional, that I have consulted with the mental health care provider regarding the advisability of working with a coach and that this person is aware of my decision to proceed with the coaching