As part of becoming a client, you will have to sign the Terms and Conditions form, sent to you by email, and return it back to me prior to your first session.
Please read the following points and sign at the end. By starting a counselling or coaching relationship through setting an appointment, you do agree to work with us under these terms.
Relationship
| I understand that counselling and coaching is a relationship I have with my counsellor/coach that is designed to facilitate the creation of development of personal, professional, or business goals and to develop and carry out strategies and plans for achieving those goals. I recognize it is my responsibility to heal, to change, and to achieve my agreed goals (which will be discussed and agreed upon during the sessions). |
Responsibility and Liability
| As a client, I understand and agree that I am fully responsible for my well-being during my sessions, including my choices and decisions. I understand that counselling/coaching is a comprehensive process that may involve all areas of my life, work, finances, health, relationships, including friends and family, self-development, education and recreation. I acknowledge that deciding how to handle these issues and implement my choices is exclusively my responsibility. All information is not to be in lieu of professional advice. I will seek professional guidance for legal, medical, financial, business, spiritual or other matters. I understand that all decisions in these areas are exclusively mine and I acknowledge that my decisions and my actions regarding them are my responsibility. I do not hold now or in the future my counsellor/coach liable for any personal choices or business decisions that I make. |
Counselling/Coaching Actions
| I recognize that change and growth occur from continuous implementation and review. I agree to follow up and perform all counselling/coaching actions, activities and special personal tasks by the agreed time frames and in the agreed format to the best of my abilities. |
Support
| I recognize that counselling/coaching is a professional modality distinct from other healing modalities and agree that should a requirement for mental health support arise that I will be referred to a suitable professional in this field. I agree to share any personal fears, limitations, and creative ideas with my counsellor/coach that could hold me back from or help me achieve my agreed goals. |
Intellectual Property
| Given this program may contain the intellectual property of Nathalie Himmelrich Grief & Trauma I agree that I will not reproduce any material, train or present this program in any format without the written permission of Nathalie Himmelrich Grief & Trauma. |
Confidentiality
| I understand that during the course of the counselling/coaching, we may discuss future plans, business affairs, customer lists, financial information, job information, goals, personal information and other private information. I’m aware that my counsellor/coach will never voluntarily communicate my information to a third party without my express permission. Exceptions to this are as part of the requirements of Supervision, in case of threatened harm to a third party and if legally required to do so being subpoenaed by a court. |
Payment
| I agree to pay the counselling/coaching fee prior to the session and prepay for any program or package by paying the PayPal invoice sent to me. Sessions will only occur once full payment has been received. Counselling packages are valid for: • 6 months for a package of 5 sessions, or • 12 months for a package of 10 sessions. I recognize that my paid fees for packages are non-refundable. To engage myself fully in a coaching program I am committing to completing the entire program. If for any unforeseen circumstances I am unable to complete this program, if I am asked to leave or if I choose to leave the program, I recognize that my paid fees or any part thereof are non-refundable. |
Time Frame
| I understand that each counselling/coaching session consists of a certain amount of time, depending on the agreed time frame. I agree that any extra time including any research or additional work by the counsellor/coach that goes beyond the scope of the session or agreed package will be charged by 15-minute blocks at the pro-rata hourly rate by mutual agreement in advance. I understand that my session time will end at the scheduled time. Should I arrive late, I agree to pay the full fee. |
Cancellation
| I understand that at least 24 hours notice is required when cancelling an appointment. I agree to pay the full session fee for either a late cancellation or a missed appointment. |
Saying Goodbye
| Should I feel that I no longer wish to be in counselling/ coaching – whatever the reason – I will complete the contact with my counsellor/coach in the last appointment with understanding and good-will. |
Commitment & Feedback
| I agree to provide my counsellor/coach with feedback during and following the sessions or program. I will ensure I give feedback if my needs are not being met along the way. If I perceive my expectations are not met during the sessions, it is my responsibility to address this during the session. In signing these Terms and Conditions I acknowledge my personal and full commitment to my counselling/coaching and agree that if I do not follow through with any of these terms that our relationship may be terminated. |
I agree to participate and play full out!
I, _______________________________________ (print name):
I have carefully read and understood the Welcome Guide, the Terms and Conditions and I have answered all of the questions in the Client Intake Form fully, accurately and to the best of my abilities.
Signed Date
