Your name *

Phone number *

Do you know your Enneagram Number? *

Preferred Meeting Method *

I agree for Erin Slutsky to coach me. She agrees to hold the contents of our sessions completely confidential. * *

I understand that we are both responsible for creating a successful coaching relationship, which will support me in reaching my goals and living my life to the fullest. *

I understand any advice or suggestions given by the coach are done so on the clear understanding that I, at all times, remain responsible for my decisions, actions and outcomes of those actions, and that the coach does not in any way share that responsibility. *

I agree to share relevant information with Erin*

I agree to make requests of her when my needs are not being met. *

I agree to disagree openly with her as appropriate. *

I agree to test our assumptions. *

I agree to deal with other obstacles, as they arise. *

I give Erin permission to challenge me with powerful questions *

Request homework assignments *

Provide inquiries for me to think about *

Challenge and hold me accountable *

I agree to the following business items: Fee of $77 per session * or agreed upon package fee

Payment is due at time of service. Please specify how you will be paying. *

If I am late for an appointment, my session is shortened accordingly. *

If I miss an appointment without 24-hour notice, I will be charged for the appointment. *

Rescheduling with more than 24-hour notice results in no charge as long as both of us can fit it into our schedule. *

One no-show or cancellation without rescheduling merits a phone call from Erin. *

Two no-shows or cancellations can lead Erin to terminate our relationship. *

Please Sign and Date Below *