Coaching with Vanessa Van Life Girl Coach - Medical Disclaimer

Please complete enclosed Medical Disclaimer and click Submit at end of form. Thank you.

AGREEMENT SERVICES:The services to be provided by the coach to the client are face-to-face or zoom/ Skype-coaching, as agreed jointly with the client. Coaching may address specific personal projects, business successes, or general conditions in the client's life or profession. Coaching sessions may be recorded as needed.

Other coaching services include value clarification, brainstorming, identifying plans of action, examining modes of operating in life, asking clarifying questions, and making empowering requests or suggestions for action. Throughout the working relationship, the coach will engage in direct and personal conversations.

The client understands that successful coaching requires a co-active collaborative approach between client and coach. In the coaching relationship, the coach plays the role of a facilitator of change, but it is the client's responsibility to enact or bring about the change. If the client believes the coaching is not working as desired, the client will communicate and take action to return the power to the coaching relationship.

Prior History:The client also agrees to disclose details of the past or present psychological or psychiatric treatment. In entering into the coaching relationship, and signing the agreement, you are agreeing that if any mental health difficulties arise during the course of the coaching relationship, you will notify me immediately so that I can discuss with you appropriate steps and if any additional referrals are needed. 

Privacy:The client can, at any point in the coaching session, declare his/her preference not to discuss a specific issue, by simply stating that they would rather not discuss this issue. The coach agrees to respect this boundary and will not attempt to forward the conversation further along those lines. 

Confidentiality:All information about the coach / client relationship will remain strictly confidential except in very rare circumstances where decreed by law; ie. where the court might issue a subpoena for the file or information.If you wish for me as your coach to speak to someone outside our interactions, then you need to give me written permission (original letter, fax or email) to do so. Exceptions to confidentiality of course relate to circumstances such as intent to seriously harm someone, child abuse etc. Otherwise, all your information is confidential.It is also important to note that in some situations, it is important to be aware of the use of technology in that for some clients, there is a risk in using certain media such as the internet, mobile phones and cordless phones. If you use these to communicate with me, then I will assume that it is appropriate to continue to do so in my interactions with you. 

Termination:Coaching under the terms and aforementioned agreements will continue for the duration of the contracted period. Only under extenuating circumstance can our coaching agreement be postponed up to 1 month of the said agreement.

Coach's Information

Vanessa Donaldson

Van Life Girl Coach, LLC

Email: info@vanlifegirlcoach.com

Cell #: 808-256-8672

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