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A t t e n t i o n S o l u t i o n s

A D H D L i f e C o a c h i n g

________________________________________________________________________

12. I understand that the Coach will not be put in the position of speaking for the Person

Being Coached to me. The Person Being Coached will be encouraged and supported to

self advocate, and the Coach may facilitate a conversation between parties as part of the

learning and growth of the Person Being Coached.

13. Because the Person Being Coached may not have the presence and awareness of his/her

behavior, it may be necessary for the Coach to ask for and/or receive input from outside

sources to identify and support coaching goals. I may be asked to sign a release for such

information (from teachers, educational or mental health professionals, etc.) to be given

to the Coach. The Person Being Coached will always be informed that such information

is being received by the Coach.

14. For public behavioral goals, the Coach may need reports on progress noticed, and I

commit to making note of such behavior changes, appreciating them, and sharing them

with the Coach and the Person Being Coached.

15. I understand that the Coach may, for the purposes of professional credentialing or

renewing a credential, be required to produce a client coaching log that lists client names

and hours coached. I understand there is never any disclosure of coaching content, and

these professional organizations will handle all information with the highest regard

toward confidentiality. I agree to allow disclosure of the number of hours coached on the

Coach’s client coaching log for credentialing and credential renewal purposes.

Client Signature _____________________________________________ Date ______________

Printed Name: ______________________________________________

Client Signature _____________________________________________ Date ______________

Printed Name: ______________________________________________

Person Being Coached Signature ________________________________ Date ______________

Printed Name: ______________________________________________

Parent/guardian/client Coaching Agreement Form - A T T E N T I O N S O L U T I O N S Page 4