Mental Performance Consent Form
Please complete this Mental Performance Consent Form to confirm your understanding and agreement for participation in mental performance support sessions. All information is handled respectfully and is only used for session planning and communication.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization / Team Name
Role / Relationship to the participant
Participant Name
*
First Name
Last Name
Purpose of Mental Performance Support
*
Preferred Support Format / Session Type
*
Individual Session
Group Session
Workshop
Virtual (Online)
In-Person
Other
Consent Declaration: I confirm that I understand the purpose and nature of the mental performance support sessions, and I give my permission for participation and communication regarding these sessions.
*
I agree and give consent
Signature
*
Submit Consent
Submit Consent
Should be Empty: