Name

Date

This is a required question

Coaching is not therapy, counseling, advice giving, mental healthcare, or treatment for substance abuse or any addictive behavior. The coach is not functioning as a licensed mental health professional, therapist or counselor, and coaching is not intended as a replacement for counseling, psychiatric interventions, treatment for mental illness, recovery from past abuse, professional medical advice, financial assistance, legal counsel, or other professional services.

I understand.
Other:

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Coaching is for people who are basically well-adjusted, emotionally healthy, functioning fairly effectively, honest and straightforward and wanting to make improvements in their lives.

I am well-adjusted and emotionally healthy.
I will be honest at all times.
Other:

This is a required question

Coaching is designed to address issues the person being coached would like to move forward on. These could include personal foundation, career development, relationship enhancement, spiritual growth, healthy lifestyle management, life balance, decision-making or achieving any other short-term or long-term goal.

I am ready to coach or be coached on any identified issue or goal.
Other:

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The coaching session may involve brainstorming, values clarification, written assignments, education, research, goal-setting, developing plans, accountability, challenges, behavior changes, personal awareness, visualization and questioning.

I am open to experiment with and identify appropriate methods to reach goals.
Other:

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Coaching is a confidential relationship and the coach and the person being coached agrees to keep all information strictly confidential, except in those situations where such confidentiality would violate the law.

I understand.
Other:

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Coaching expects that the coach and the person being coached is guided by their values and beliefs. Your coach is a follower of Jesus Christ and seeks to personally live according to that commitment with integrity. We agree to respect any different values and beliefs and do not seek to impose our own values on each other. Your coach will not proselytize, judge or refuse coaching services if we do not share similar values and beliefs, but will coach within the values and beliefs and honest explorations of the person being coached.

I understand.
Other:

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Successful coaching will be an ongoing partnership that may take a month for a small issue or a number of months for a larger goal. I understand that coaching requires attention to completing weekly goals, work that may be hard and answering questions that may be difficult and require me to dig deep.

I commit to developing a partnership together.
I am ready to commit to the work necessary for coaching to be successful.
Other:

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It is understood that the coach may not commit to a face-to-face meeting if travel time is more than 30 minutes. Otherwise, the person being coached may choose face-to-face, telephone, Skype or any another acceptable method of online meeting for each session.

Face-to-face meetings preferred.
Telephone meetings preferred.
Video meetings preferred.
Other:

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The person being coached commits to emailing the completed Intake Form no later than 24 hours prior to the first session and answering all questions honestly. This will prepare the person being coached for the depth of work to come and provide the coach with information about current thoughts, practices and future desires.

I commit.
Other:

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The person being coached commits to emailing the completed Pre-Coaching Information Form, due 24 hours prior to each coaching session. This information will help pull together what has happened during the week and will help the coach and the person being coached focus appropriately for the next session.

I commit.
Other:

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We agree to the following fee information for this program.

Please read, verify and check each box.

_____ sessions.
Each session is __________ long.
Payment of $_____ by PayPal, credit card or check.
Rescheduling must be requested at least 24 hours prior to a scheduled session or session fees may be retained.

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DISCLAIMER: The client is the sole decision-maker in the coaching process. Any and all actions or consequences resulting from the coaching sessions are the responsibility of the client. The client releases the coach of all liability pertaining to the services rendered in the coaching relationship.

I read this.

This is a required question

The following signatures represent the people named. This agreement represents our mutual understanding of the coaching relationship.

I agree.

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Client Signature and Date Signed

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Coach Signature and Date Signed

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Adapted from Gary R. Collins. Used by permission of NavPress (navpress.com).

I have printed a copy for my records.

This is a required question

Amanda Bailey | Flux & Flow | Coaching Agreement