A NEW YOU-LIFE COACHING SERVICES Consent Form
A NEW YOU-Life Coaching Services
We are a licensed counseling service with over 7 years of experience specializing in various life coaching areas. We value our relationship with our clients and believe that relationships signal the healing process. we believe that coaching is "a solution-focused, result-orientated systematic process in which the coach facilitates the enhancement of work performance and the self-directed learning and personal growth of the coachee" (Grant, 2001a, p.8)
According to (Bresser & Wilson, 2010), "at the heart of coaching lies the idea of empowering people by facilitating self-directed learning, personal growth, and improved performance. We believe that each individual is different and has his/her own way of focusing on solutions. The journey of each client is different.
References:
Bresser, F., & Wilson, C. (2010). What is coaching. Excellence in coaching: The industry guide, 2, 9-20.
Grant, A.M. (2001a). Towards a psychology of coaching.
Retrieved 12 May, 2003, from:
www.psych.usyd.edu.au
Client's Rights
1. The client may ask questions on what to expect during and end result of the therapy.
2. The client may decline to proceed the counseling as to the techniques which may be conducted by the therapist.
3. The client may cease to continue counseling sessions anytime and may return to therapy anytime.
4. The coach has the right to dismiss the client from the course of therapy.
5. The client has the right to review his or her records from the life coach.
6. Right to confidentiality: Within limits provided for by law, all records and information acquired by the coach shall be kept strictly confidential in accordance to the principles of a doctor-patient relationship. All information will not be shared or revealed to any person, agency, or organization without the prior written consent of the client.
7. The client can raise any concerns and to speak with the coach immediately of any concerns provided that the therapist is likewise available to discuss matters with the client.
Please check the items that you believe is affecting you
Alcohol or drug problems Anger or hostile feelings Anxiety, nervousness, fears Sadness or Depression Eating or appetite problems Family issues Procrastination Physical distress Relationship/marital concerns Sexual concerns Shyness Traumatic experiences Social conflicts Suicidal feelings or behaviors Stress Sleep disorder Self-control Self-esteem or confidence Work or career concerns
Acknowledgement
I have reviewed this A NEW YOU Informed Consent Agreement. I likewise understand my Client's Rights set in this form.
I accept this agreement and consent to counseling.
Client Name
First Name Last Name
Email
example@example.com
Phone Number
Area Code Phone Number
Address
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code
Client Signature
Clear
Date Signed
Month Day Year
Date
A NEW YOU-LIFE COACHING SERVICES
Should be Empty:

A NEW YOU-LIFE COACHING SERVICES Consent Form

A NEW YOU-LIFE COACHING SERVICES