Intake Forms (Coaching)

Coach’s Role

1. Co-create a collaborative partnership that supports you to deepen self-awareness, enhance creative ability, foster personal mastery, and cultivate your full potential.

2. Ask timely and appropriate questions that foster and support greater self-awareness and inner resourcefulness, and assist in working through any personal roadblocks/obstacles (conscious or unconscious) that may arise.

3. Honor that some experiences/things in life are private, which you may or may not choose to share or explore as part of these coaching sessions.

4. Facilitate effective coaching processes/techniques designed to help tap into your own inherent wisdom/insights, work through any perceived challenges, and explore creative possibilities and potential.

Client’s Role

1. Commit to a coaching relationship/partnership that supports my abilities to:
a. Deepen self-awareness and strive to identify whatever challenges, issues, and/or opportunities you may be experiencing.

b. Become aware of and commit to working through any blind spots, roadblocks, or obstacles to success that may arise.
c. Utilize emerging insights/learning to enhance your personal/professional growth and development.

2. Take responsibility for my own actions and behaviors.

3. Be intentional about making empowering, conscious choices that truly reflect and support my needs/desires/goals in life.

4. Follow through and be accountable for the completion of any action planning steps/activities generated as a result of each coaching session.

Coaching Agreement

1. As a client, I understand and agree that I am fully responsible for my physical, mental and emotional well-being during my coaching conversations, including my choices and decisions. All coaching topics/issues for discussion are my choice. I am aware that I can choose to discontinue coaching at any time.

2. I understand that my coach will coach in a manner which reflects the ICF Core Competencies and upholds the ICF code of ethics, as well as the Code of Ethics including but not limited to maintaining confidentiality of ALL my client information unless I state otherwise, in writing, except as required by the law.

3. I understand that coaching is a professional client-relationship I have with my coach that is designed to facilitate the creation/development of academic and personal goals and to develop and carry out a strategy/plan for achieving those goals.

4. I understand that coaching is a comprehensive process that may involve all areas of my life, including work, finances, health, relationships, and recreation. I acknowledge that deciding how to handle these issues and implementing my choices is exclusively my responsibility.

5. I understand that coaching does not involve the diagnosis or treatment of mental disorders as defined by the DSM-IV published by the American Psychiatric Association. I understand that coaching is not a substitute for counselling, 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.

6. I will not use coaching as a substitute for counseling, psychotherapy, mental health care or substance abuse treatment. I recognize that I am seeing this professional as a coach and not a licensed mental health professional, advisor, consultant or mentor.

7. I give my coach permission to keep a confidential record of my name, and contact info in order to meet the requirements for coach credentialing by the International Coaching Federation: ICF: www.coachfederation.org. I agree to allow my coach to document coaching hours with me for submission to the ICF for continued learning and certification as a coach.

8. I understand that coaching is not to be used in lieu of professional advice. I will seek professional guidance for advice regarding academic, legal, medical, financial, business, spiritual or other matters.

9. I agree to the payments of $140 CAD. plus GST, after each session as discussed and agreed with the coach.

*Please be on time to all appointments. If you will be late, notify your coach in advance. If you will miss an appointment, notify the coach at least 24 hours in advance. Appointments missed without 24 hours notice will be charged a session fee.

*Be honest and participate fully. Recognize that our sessions are a safe place to look at what you really want and what it will take to make it happen.

*Make a commitment to the action plans you create, and do what you have agreed to do.

*Understand the power of the coaching relationship can only be granted by you and commit to making the relationship powerful. If you see that the coaching is not working as you desire, communicate and take action to notify your coach of what is not working for you.

I understand that all decisions in these areas are exclusively mine and I acknowledge that my decisions and my actions regarding them are my responsibility. I have read and agree to the above:

“You are about to take your life to a whole new level. As you step forward now you will be taking a huge leap towards making your life even more of a unique masterpiece. Welcome aboard!”

The Clients signature on this agreement indicates compliance with the above requests and understanding of the services to be provided.