Heart Mender Session/ Coaching Agreement

Client Name:

This agreement, between Heart Mender Specialist and Coach, Brenda D. Ballantine M. A. and the above named client will begin on ________________ and will continue for a period of 3 months ending on ________________. If said client desires to continue for additional length of time, current rates and time frames for each session will remain the same.

Fees

The initial phone consultation is free of charge. The fee for the following sessions is $120.00 per hour, paid in advance. Cancellations  require 24 hours notice, to avoid charges for the appointment.

Services

The services to be provided by the coach to the client are face-to-face or telephone-coaching, as agreed jointly with the client.  Coaching may address specific personal challenges, projects, business successes, or general conditions in the client’s life or profession.  Other coaching services include value clarification, brainstorming, identifying individual plans of action, examining the 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 bring to the attention of the coach so that the coach may re-direct while moving forward in their working relationship.

The client will inform the coach if the client desires to add a spiritual component to the session, the coach will work within the agreed boundaries in that area.

 Prior History

The client agrees to disclose details of prior history of mental health, or present psychological or psychiatric treatment.  Coaching and counseling are not the same and as such, there needs to be a clear distinction between the two.  Although Brenda Ballantine is a mental health professional, she is not engaging in therapy with coaching clients. Her training, education, skills, knowledge and tools, will be combined to assist the client to achieve their highest potential and life goals.

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.

Confidentiality

All information about the coach / client relationship will remain strictly confidential except in very rare circumstances where decreed by law; or subpoena by a court of law. Exceptions to confidentiality will be applied in circumstances such as intent to seriously harm self and/or others, child or elder abuse.

The use of the Internet and mobile phone technology includes the risk of a confidentiality breach. The client understands this risk and agrees to hold the coach harmless in the case of a confidentiality violation due to this technology.

Termination

The coach and client agree to provide each other with a two weeks notice in the event that it is desired to terminate coaching.  Otherwise, the coaching will continue for the duration of the agreed time period.

Signatures

In witness of their agreement to the terms above, the parties hereby affix their signatures:

____________________________

Coaching Client / Date

____________________________

Executive & Personal Coach / Date