Client Agreement

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Client Agreement

Please fill in this form before we begin working together. A copy of your responses will be emailed to you following submission.

As we embark on this journey together, or as you are considering it, I would like you to know I am committed to doing my best to create a safe space for you to explore, reflect, confront challenges, experiment and learn with new ways of communicating with yourself and others.

I offer empathy sessions, and an embodied approach to coaching using Nonviolent Communication(NVC) authentic movement, therapeutic parts work and NLP processes. I also offer NVC mentoring and supervision for coaches and trainers. We agree how we will work together.

My intention is to treat you and others with respect and compassion. I welcome feedback including: being called into awareness if you think I am not understanding matters concerning mental health, equality, equity, culture, gender, sex and race and anything else.

What you tell me is confidential (see below for more information about this) I do share about work in my own supervision sessions, the identity of my clients is never shared. I engage in CPD. You can read more about the way I work here, Terms and conditions here. My Biography and association memberships are listed here If you have any questions, please let me know.

We will discuss this agreement and distinguish between coaching, mentoring, NLP, NVC and professional supervision services when we meet.

Email *

Full Name (first name followed by surname and any mode of address you wish to share with me) *

Year of birth *

Your contact phone number *

Address (including postcode) *

Emergency contact (name and contact information) *

Please tell me how you heard about me

What would you like to achieve from receiving Coaching/Mentoring/Supervision? *

Do you have any fears, concerns, medical conditions or special needs that could impact our work together? *

Yes

Maybe

If you have answered 'yes' or 'maybe' above, please say more (or skip to next question if your answer was 'no')

Is there anything else you want me to know?

For clarity about the limitations of this work, and to protect you, me, and the coaching profession against public discredit, please tick each box to show you have understood and agree.*

Tracy's services are for Coaching and mentoring/supervision/ conflict resolution or educational purposes

Her services are not in any way diagnostic, nor a substitute for medical care where needed

You take full responsibility for any actions you choose as a result of working together

What you share will remain private and confidential to the extent permissible by law

You agree to paying the full agreed fee for the session unless 24 hours notice is given for cancellation

You agree to pay the fee before the session unless otherwise agreed

Agree to being attentive to reflective and open to learn and let me know if any strategies were not effective for you

Required

I understand Tracy Seed's services are not to be used as a substitute for counselling, psychotherapy, psychoanalysis, mental health care, substance abuse treatment, or other professional advice by legal, medical, or other qualified professionals. It is my exclusive responsibility to seek such independent professional guidance and advice as needed.

I understand and agree to the above statement

Required

If I, (the client) am currently under the care of a mental health professional, I will seek advice from about engaging with this service, prior to joining sessions.

I understand and agree to the above statement

Required

I will not call Tracy Seed as a witness, or require her to share any content of the sessions, in any litigation, formal or informal legal process. If a court order requests the notes as evidence, I will fully indemnify Tracy Seed in respect of any costs, fees or expenses, including legal costs, incurred in resisting or responding to such an application.

I understand and agree to the above statement

Required

Safeguarding

If Tracy thinks a child is at risk of harm or your life is in danger, she would firstly speak to me about my concerns. If she continues to be concerned, she would refer her concerns onward to a relevant contact (which could be a legal authority if her concerns escalated or it was her legal duty), to access extra support.

I understand and agree to the above statement

Required

Data Protection

This registration information and your session notes are stored electronically on my computer and in the cloud. You can request complete copies of the records I hold, at any time. I will keep the content of our sessions and your personal details and data, private, to the extent permissible by law. You can read my privacy policy and terms and conditions at www.tracyseed.com

A copy of your responses will be emailed to the address you provided.

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