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TBI Coach
Brain Injury Coaching Agreement

Name: _______________ _____________________________________
Plan: ______________________________________________________
Sessions per Month: _________________________________________
Term of Agreement: ____ Quarterly            ____ Month to Month
Fees: $ _________ For Three Months    $____________Per Month
Session Day and Time: _________________________________________  

Ground Rules:           1. Coach calls the client at the appointed time.
                                   2. Client pays coaching fees in advance.

1.      As a client, I understand and agree that I am fully responsible for my well-being during my coaching calls, including my choices and decisions. I am aware that I can choose to discontinue coaching at any time. I recognize that coaching is not psychotherapy and that professional referrals will be given if needed.

2.      I understand that life coaching is a relationship I have with my coach that is designed to facilitate the creation/development of personal goals and to develop and carry out a strategy/plan for achieving those goals.

3.      I understand that TBI Coaching is a 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 and implement my choices is exclusively my responsibility.

4.      I understand that TBI coaching does not treat mental disorders as defined by the American Psychiatric Association. I understand that life 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 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 this person regarding the advisability of working with a life coach and that this person is aware of my decision to proceed with the life 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 shared with other life-coaching professionals for training or consultation purposes.

8.      I understand that life coaching is not to be used in lieu of professional advice. I will seek 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 responsibility.

    I have read and agree to the above.

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