Life Coaching Agreement

Please review, adjust, sign where indicated, and return to me by e-mail or fax. If you have questions, consult with me before signing.


Name:____________________________________________________________

Please choose one of the following life coaching packages:


    1) 5X5 PACKAGE

    You receive a 1 hour initial session, followed by 1 hour weekly sessions over a 5 week period.

    Fee: $ 600.00


    2) 9X9 PACKAGE

    You receive a 1 hour initial session, followed by ½ hour weekly sessions over a 9 week period.

    Fee: $ 600.00


    3) 5 BI-WEEKLY PACKAGE

    You receive a 1 hour initial session, followed by 1 hour bi-weekly sessions over an 8 week period.

    Fee: $ 600.00


    4) CREATE YOUR OWN PACKAGE

    1 hour assessment session:___1_____session

    Number of 1 hour sessions:_________sessions

    Number of ½ hour session:_________sessions

    Total number of sessions:__________X $120.00/hr. = $____________


Package Chosen: #_______


First Session Date:_______________________ Session Time:____________
(If unsure about first session date or time, please call to arrange)

Ground Rules:

  • Client calls the coach at the scheduled time.
  • Client pays coaching fees in advance.
  • Client pays for long-distance charges, if any.

  1. I understand that life coaching is a relationship with a life coach that is designed to facilitate the establishment of long-range goals and short-term objectives and the achievement of those goals.

  2. I understand that the role of the life coach is to assist me to improve the quality of my life.

  3. I understand that life coaching is comprehensive in that it deals with almost all areas of my life including work, finances, health, education, relationships, and spiritual issues. I acknowledge that deciding on how to handle these issues and implementing my decisions remains my exclusive responsibility.

  4. I understand that life coaching is for people who are already basically successful, well adjusted, and emotionally healthy.

  5. I understand that the confidentiality in the life coaching relationship is limited. Confidentiality will not apply to certain crimes that have either been committed or are planning to be committed. Such crimes may need to be reported to legal authorities. It is also possible that certain topics discussed could be reviewed with other life coaching professionals for training and development purposes.

  6. I understand that life coaching does not treat mental disorders as defined specifically in the DSM-IV. If I have anything in my past indicating that I have an unresolved and serious emotional or physical problem or a mental disorder, then I certify that I am not using life coaching as a substitute for assistance from a mental health professional or a medical doctor.

  7. I will not use life coaching as a substitute for counselling, psychotherapy, psychoanalysis, mental health care, or substance abuse treatment.

  8. If I am currently in therapy or under the care of a mental health professional, I will have consulted with that person regarding the advisability of my working with a life coach. Additionally, I will inform my life coach of this relationship.

  9. I will not use life coaching in lieu of professional medical advice, legal counsel, accounting assistance, business consulting, or spiritual guidance and for each of these areas I understand I should consult the appropriate professionals. I acknowledge that I will not use life coaching as a substitute for such professional guidance. I further acknowledge that all decisions on dealing with these issues lie exclusively with me.

  10. I agree to complete regular evaluations of the life coaching process and notify my life coach immediately of any concerns.

SIGNATURE. I have read and agreed to the above. I will comply with all the points in this agreement. It is understood that our relationship may be discontinued whenever these terms are not fulfilled by either of us.


Signature:_______________________________________Date:____________

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