Sample Coach Agreement Form Page 2

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1. As a client, I understand and agree that I am fully responsible for my physical, mental and
emotional well-being during my coaching calls, including my choices and decisions. I am
aware that I can choose to discontinue coaching at any time.
2. I understand that “coaching” is a Professional-Client relationship I have with my coach that is
designed to facilitate the creation/development of personal, professional or business goals
and to develop and carry out a strategy/plan for achieving those goals.
3. I understand that coaching is a comprehensive process that may involve all areas of my life,
including work, finances, health, relationships, education and recreation. I acknowledge that
deciding how to handle these issues, incorporate coaching into those areas, and implement
my choices is exclusively my responsibility.
4. I understand that coaching does not involve the diagnosis or treatment of mental disorders
as defined by the American Psychiatric Association. I understand that coaching is not a
substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance
abuse treatment and I will not use it in place of any form of diagnosis, treatment or therapy.
5. I promise that if I am currently in therapy or otherwise under the care of a mental health
professional, that I have consulted with the mental health care provider regarding the
advisability of working with a coach and that this person is aware of my decision to proceed
with the coaching relationship.
6. I understand that information will be held as confidential unless I state otherwise, in writing,
except as required by law.
7. I understand that certain topics may be anonymously and hypothetically shared with other
coaching professionals for training OR consultation purposes.
8. I understand that coaching is not to be used as a substitute for professional advice by legal,
medical, financial, business, spiritual or other qualified professionals. I will seek
independent 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 sole responsibility.
I have read and agree to the above.
Client Signature
________________________________________________
Date:____/____/____
Creation Coach - 9163 Sugar Run Rd. NE – Copper Hill, VA 24079 - phone (540) 491-0343

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