Soul Care Intensive
DISCLOSURE & CONSENT AGREEMENT
I UNDERSTAND THAT COACHING IS NOT THERAPY OR COUNSELING, AND IT DOES NOT PROVIDE MEDICAL ADVICE OR TREATMENT.
I AGREE TO PARTICIPATE FULLY IN THE COACHING PROCESS, INCLUDING COMPLETING HOMEWORK ASSIGNMENTS AND ACTIVELY ENGAGING IN SESSIONS.
I UNDERSTAND THAT COACHING SESSIONS ARE CONFIDENTIAL, WITH EXCEPTIONS AS REQUIRED BY LAW.
I WILL ONLY RELEASE INFORMATION ABOUT OUR WORK WITH YOUR WRITTEN PERMISSION, OR IF I AM REQUIRED BY COURT ORDER.
THE FOLLOWING EXCEPTIONS WILL APPLY:
• THERE ARE A BROAD RANGE OF EVENTS THAT ARE REPORTABLE UNDER CHILD PROTECTION STATUTES. PHYSICAL OR SEXUAL ABUSE OF A CHILD WILL BE REPORTED TO CHILD PROTECTIVE SERVICES. WHEN THE VICTIM OF CHILD ABUSE IS OVER AGE 18, I AM NOT LEGALLY MANDATED TO REPORT IT UNLESS I BELIEVE THAT THERE ARE MINORS STILL LIVING WITH THE ABUSER WHO MAY BE IN DANGER OF BEING ABUSED. ELDER ABUSE IS ALSO REQUIRED TO BE REPORTED TO THE APPROPRIATE AUTHORITIES.
• IF YOU ARE AT IMMINENT RISK TO YOURSELF OR SOMEONE ELSE OR MAKE THREATS OF IMMINENT VIOLENCE AGAINST ANOTHER PERSON, I WILL TAKE APPROPRIATE ACTION.
ACKNOWLEDGMENT AND RELEASE OF LIABILITY
BY SIGNING THIS DISCLOSURE AND CONSENT AGREEMENT, I ACKNOWLEDGE THAT I UNDERSTAND THE ABOVE INFORMATION.
I AGREE TO HOLD HARMLESS MY LIFE COACH FROM ALL LIABILITIES AND CLAIMS WHICH MAY ARISE AS A RESULT OF MY PARTICIPATION IN LIFE COACHING.