Inspire Wellness: Personal Fact Sheet and Client Agreement
All personal information is strictly confidential and treated appropriately.
Date of Birth
Name of Significant Other
Significant Other's Date of Birth
Names and Ages of Children
I understand that coaching does not provide treatment, therapy, or diagnosis and I agree to see my physician, therapist or qualified helping professional for such needs. I am the expert in my own life. I acknowledge full responsibility for myself to the best of my present abilities and awareness. I agree to wholeheartedly participate with my coach to make my coaching experience positive and useful. I agree to meet all financial responsibilities promptly unless other arrangements have been made. I understand that a charge will be made for all time reserved unless cancelled 24 hours in advance. Entering my name below acts as my electronic signature indicating that I understand and agree with these statements.
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