Coaching Consent & Acknowledgment Form

Client Name: ________________________________
Date: ________________________________

Purpose of Coaching

I understand that coaching is a collaborative, supportive process designed to encourage personal growth, emotional well-being, spiritual reflection, and practical clarity. Coaching is not therapy, counseling, pastoral care, or medical treatment.

Scope of Practice

I acknowledge that the coach does not diagnose, treat, or heal mental health conditions, and does not provide crisis intervention. Coaching does not replace professional mental health, medical, or pastoral services.

Confidentiality

I understand that all coaching sessions are confidential, except where disclosure is required by law (including situations involving risk of harm to myself or others).

Personal Responsibility

I acknowledge that my progress depends on my own willingness to be honest, reflective, and engaged. I understand that results are not guaranteed.

Boundaries & Communication

I understand that coaching support is provided during scheduled sessions. Communication between sessions is limited to brief scheduling matters unless otherwise agreed upon.

Scheduling & Cancellation Policy

I understand that sessions are 60 minutes in length and begin and end on time. I agree to provide at least 24 hours’ notice for cancellations or rescheduling. Late cancellations may be charged the full session fee.

Spiritual Practices

I understand that prayer or spiritual reflection may be included if I request it. Coaching respects my personal faith, values, and boundaries.

Emergency & Crisis Disclaimer

I understand that coaching is not appropriate for emergency situations. In the event of a crisis, I agree to seek immediate help from local emergency services, a trusted pastor, counselor, or medical professional.

Consent & Agreement

By signing below, I confirm that I have read, understand, and agree to the terms outlined above, and consent to participate in coaching.

Client Signature: ________________________________
Date: ________________________________

Coach Signature: ________________________________
Date: ________________________________

Client’s Name: _____________________________________________