Client Agreement & Waiver
Grief Support & Life Coaching
By purchasing services from the services provider / Life Pivot Healing LLC, the Client acknowledges and agrees to all of terms listed below.
Please initial each section to signify acceptance of the terms.
_______ Services & Code of Ethics - Grief Support & Life Coaching
Grief Support and Life Coaching are coach-client relationships designed to support, encourage, and empower the Clients as they navigate grief or set goals for the future.
• Grief Support Coaching provides the space for clients to process, honor, and gently begin to integrate your loss on your timeline.
• Life coaching is an organic and flexible engagement process that that supports personal growth my clients are seeking through reflection, intention setting, and focused action. This is the space for exploring your next chapter and taking aligned steps toward your goals.
• Your needs may shift and support can shift with you from Grief Support to Life Coaching and back again as needed. This is an adaptable, heart-led path we walk together.
PLEASE READ: Grief Support and Life Coaching are not counseling, therapy, or mental health treatment. The Client accepts this distinction as defined by EMPA:
Therapy (counseling or psychotherapy) is intended to help people recover from emotional or other psychological disorders such as depression or anxiety. Therapy is a long-term process in which a client works with a healthcare professional to diagnose and resolve problematic beliefs, behaviors, relationship issues, feelings and sometimes physical responses. Therapists are licensed professionals.
Coaching, on the other hand, is intended to help normal, healthy individuals achieve personal goals such as enhanced performance or improved work-life balance. etc. In coaching, a client works with a coach who is not a healthcare professional to clarify goals and identify obstacles and problematic behaviors in order to create action plans to achieve desired results.
If the Client experiences suicidal thoughts, severe emotional distress, or symptoms of a mental health issue, they agree to seek care from a licensed therapist, counselor, or medical provider.
Code of Ethics: The services provider agrees to maintain the ethics and standards of behavior established by the International Coach Federation (ICF)(www.Coachfederation.org/ethics ).
_______ Logistics, Termination, & Refund Policy
Coaching Services Overview
Logistics: All Coaching Sessions are 50 minutes long and held virtually over Zoom.
Rescheduling or Cancelation of Sessions
It is the Client's responsibility to notify the services provider at least 24 hours in advance of a scheduled session of the need to reschedule or cancel. The services provider will try in good faith to reschedule within the week to maintain a consistent cadence.
The services provider reserves the right to reschedule or cancel sessions with reasonable notice due to illness or other circumstances.
Availability: The services provider can be available to the Client by email between scheduled meetings for non-urgent administrative matters such as scheduling, but all coaching will occur during formal sessions.
Termination & Refunds
Termination of coaching engagement: Either the Client or the services provider may terminate coaching at any time with written notice via email.
No refunds will be offered for sessions canceled with less than 24 hours’ notice via email.
No refunds will be offered for sessions that take place, even if they last a shorter period of time than the stated session duration.
Prepaid Packages: Any prepaid sessions that are both un-redeemed AND not yet scheduled after termination will be refunded.
_______ Service Provider Credentials & Training
Certified Grief Educator / David Kessler-Grief.com
Life Coach / ACC certification in progress via International Coaching Federation (ICF)
Reiki Master/Teacher (Usui and Holy Fire)
Usui Reiki I, II, & III (Master/Teacher Jamie Butler)
Holy Fire I, II, & III (Master/Teacher Patricia Lane)
Certified & Advanced Crystal Healer / Love & Light School of Crystal Therapy
35 years in strategic program and change leadership at a Fortune 500 company
_______ Confidentiality
This Grief Support / Life Coaching relationship, as well as all information (documented or verbal) that the Client shares with the services provider as part of this relationship, is bound by the principles of confidentiality set forth in the ICF Code of Ethics.
The Client acknowledges that the Coach-Client relationship is not considered a legally confidential relationship (like the medical and legal professions).
The services provider maintains session notes for the purposes of coaching continuity and accountability tracking; all such notes are maintained digitally and destroyed at the end of the coaching engagement. The Client understands that these notes are for the services provider’s review only and not part of the coaching process.
The services provider will not share e a Client’s name as a reference without Client’s consent.
“Confidential Information” does not include information that:
1) was in the services provider’s possession prior to it being furnished by the Client
2) is generally known to the public or in the Client’s industry
3) the services provider is required by statute, lawfully issued subpoena, or by court order to disclose
4) is disclosed to the services provider and as a result of such disclosure the services provider reasonably believes there to be an imminent or likely risk of danger or harm to the Client or others
5) involves illegal activity
The Client acknowledges that while the services provider takes reasonable steps to maintain privacy, no online or electronic platform is ever 100% secure.
_______ Coach-Client Engagement
If the Client is currently under the care of a mental health professional, it is recommended that the Client promptly inform the mental health care provider of the nature and extent of the coaching relationship agreed upon by the Client and the services provider.
The Client agrees to communicate honestly, be open to feedback and assistance, create the time and energy to participate fully in the program, and take full responsibility for their choices, actions, and growth.
The Client is solely responsible for creating and implementing his/her own physical, mental and emotional well-being, decisions, choices, actions and results arising out of or resulting from the grief support / life coaching relationship and their support calls and interactions with the services provider The Client agrees that the services provider is not and will not be liable or responsible for any actions or inaction, or for any direct or indirect result of any services provided by the services provider.
If the Client expresses intent to harm themselves or others, the services provider reserves the right to pause the grief support / life coaching relationship and refer the Client to emergency or crisis services. The services provider may contact authorities to ensure everyone’s safety.
________ Limited Liability
The Client agrees that in no event shall the services provider be liable to the Client for any indirect, consequential, or special damages. Notwithstanding any damages that the Client may incur, the services provider’s entire liability, and the Client’s exclusive remedy, shall be limited to the amount actually and literally paid by the Client to the services provider under the signed Client Agreement for all Grief Support / Life Coaching services rendered through and including the termination date.
The Client voluntarily participates in coaching services and accepts full responsibility for their choices, actions, and results.
The Client releases and discharges the Coach and Life Pivot Healing LLC from any and all claims, liabilities, or damages, including but not limited to personal, emotional, psychological, or financial loss.
Under no circumstances shall the Coach or Life Pivot Healing LLC be liable for any indirect, incidental, special, or consequential damages that result from the coaching relationship.
The Client agrees to hold the Coach and Life Pivot Healing LLC harmless in perpetuity, including from any legal claims arising out of the coaching engagement.
The Client agrees that the services provider makes no guarantees, representations, or warranties of any kind or nature - express or implied - with respect to the grief support or life coaching services negotiated, agreed upon, and rendered.
If a dispute arises that cannot be resolved by mutual consent, the Client and services provider agree to mediate in good faith for up to 60 days after notice given. If the dispute is not so resolved, and in the event of legal action, the prevailing party shall be entitled to recover attorney’s fees and court costs from the other party.
By purchasing these services, the Client acknowledges that they have read, understood, and voluntarily agree to the ALL of the terms outlined in this waiver.
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Client Signature Services Purchased
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Date Signed