Coaching and Informed Consent Agreement

SERVICES OFFERED: The focus of tele-coaching /mentoring is development and implementation of strategies to help reach client identified goals.  Coaching utilizes personal strategic planning, values clarification, brainstorming, and support.  

In addition to being a coach, I am also a licensed clinical counselor in the state of Ohio.  Although there are some similarities between coaching and psychotherapy, I, as a coach, will not be conducting psychotherapy.  

COACHING SERVICES: There are major differences between coaching and psychotherapy, specifically with goals, focus, and levels of professional responsibility. Coaching focuses on where clients are now, and what they'll do to get to where they want to be.

Psychotherapy, in contrast, is a health care service with a primary focus to identify, diagnose, and treat mental health disorders.  Appropriate referral for mental health treatment will be made if it's determined client would benefit from psychotherapy.  

Coaching isn't a substitute for appropriate mental health care.

CONFIDENTIALITY: Client identity and information discussed will be kept confidential with some exceptions: 1] Client gives written permission to share  2] Information related to neglect, sexual / physical abuse of a child or elderly person will be reported to appropriate agency  3] Information related to client posing current risk of harm to themselves or others will be shared with appropriate person/agency and 4] Information will be shared if required by lawful subpoena.

Usually, clients will be involved in the reporting process, and minimally will be made aware of any report that needs to made.

PAYMENT: This agreement will begin upon receipt of the first payment.  Sessions will be 40 minutes in length and have a fee per hour rate of $75.

Payment is to be made 24 hours prior to appointment through payment link on website (www.anxietymedic.info).  Session won't be held if no payment has been received.

Cancellations made prior to the start of the appointment, can be rescheduled for a future time.

Acknowledgement and Release of Liability: By signing this disclosure and consent statment, I acknowledge that I understand the above information.  I agree to hold harmless Ms. Snyder, from all liabilities and claims which may arise as a result of my participation in this coaching relationship.

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