Life Coaching & Spiritual Direction Agreement
Intent & Consent Form

Please read and complete below to get started...

Professional Confidentiality Limits: 
Your life and struggles are safe in the confidential world of life coaching/spiritual direction. Exceptions to this are where it is required by law to disclose information:

  1. If you are a danger to yourself
  2. If you are a danger to others (threats of harm, child abuse/neglect)
  3. If you are a danger to a community safety or national security
  4. It the courts subpoena client records.

Collaboration: 
The DFR Care Centre Staff works as a team to provide the best care possible. Your life coach may consult with the Care Centre Director or other professional helping staff to glean insights and ideas for better effectiveness, and for professional proficiency and training purposes.

Financial Information:
Coaching fees are due at the time of the session.


Method of Payment:
Cash, Cheque, E-Transfer or PayPal (if from the US, pay amount in USD). 

Cancellation Policy:
Unless an emergency, clients understand that 24 hours notice is required to cancel a session without paying the full session fee. 

I Understand: 
  • I am fully responsible for my wellbeing during my sessions, including my choice and decisions. I am aware that I can choose to discontinue at any time. 
  • Life coaching is a 2-way relationship I have with my coach that is designed to facilitate the development of a fruitful life, and I will intentionally express how my coach can assist.
  • Life coaching is a comprehensive process that may involve all areas of my life, (example: work, finances, health, relationships, education, sports, and recreation) and deciding what to do in these areas is my responsibility.
  • A Life Coach helps a person move forward in embracing obstacles as opportunities. A Spiritual Director helps a person hear God’s voice to deepen relationship with God; discover, attend to, and savor His presence. These sessions are not psychotherapy.
  • Life coaching is not a substitute for counseling or psychotherapy and I will not use it in place of any form of therapy. I agree that I am ready to receive coaching and spiritual direction services.
  • Information shared is confidential unless I state otherwise, in writing. However, I understand that if I report abuse, neglect, or threaten to harm myself or someone else, necessary actions will be taken, and my confidentiality agreement is limited in this capacity.
  • I am responsible for the fees if I cancel a session with less than 24-hours notice. Missed sessions will not be made up.
  • I am choosing to participate in sessions with Merri Ellen Giesbrecht and Doing Family Right Ministries. I understand that it is my responsibility to consult with my primary health care provider and/or mental health professional prior to participating and that this person is aware of my decision to process with the life coaching/spiritual direction relationship.
  • Should I choose not to consult with my health care provider, I accept full responsibility and waive all rights to liability or any claims against Merri Ellen Giesbrecht, Doing Family Right Ministries, or any affiliated administrators, or employees. I, my heirs, or legal representatives forever release, waive, discharge, and covenant not to sue Merri Ellen Giesbrecht, Doing Family Right Ministries, or any employees, for any injury, harm or death caused by either negligence or other acts. 
* I have read and understand the information above and give consent to continue coaching under the above-mentioned conditions.

* By completing the following, I agree to the terms stated above and submit the typing of my name as my digital signature.

(I also know I may receive occasional email updates to which I can choose to unsubscribe at any time.)
 

Looking forward to walking with you!

Moving you from stuck 
…to walking in God’s promises 
…and His calling for your life.