HEALTH COACHING AGREEMENT: 6 Private Coaching Sessions

Dear Participant, 

Please read the following and ask questions if needed.

I acknowledge that the information and recommendations provided in individual coaching session(s) are not intended as a substitute for medical diagnosis or advice.

I acknowledge that if I am suffering from conditions requiring medical attention or if I have symptoms that concern me, I should consult a qualified medical practitioner.

I acknowledge that I should not stop, modify, or delay conventional treatment or medications for any reason without consulting a doctor.

I understand that I should always discuss any fitness regime, dietary changes or supplements with my doctor or medical provider.

I understand that participation in physical activity may be potentially hazardous. I further understand that there may be risks, such as increased risk of gallstones and fluctuations in blood sugar, when making dietary changes. I understand that it is my choice and my responsibility, in conjunction with my physcian, whether I make any physical activity or dietary changes.

I understand that the purpose of private health coaching session(s) is to help me make positive and lasting changes that increase my health and wellbeing, and that the service will be provided by a National Board Certified Health and Wellness Coach and Registered Dietitan Nutritionist in the state of Colorado.

I acknowledge that I take full responsibility for my life and well-being, and all decisions made during and after this program.  


I understand that my clients have busy schedules and I take pride in respecting that. Please be on time. If you need to cancel or reschedule the appointment, you must do so 24 hours in advance; otherwise, you will forfeit that appointment and will not have an opportunity to reschedule it. 

The 6 coaching sessions must be completed within a two month timeframe in order to give you the informational and inspirational boost you signed up for. Any coaching session which has not been completed within this timeframe is forfeit.


The cost of your six private coaching session package is $597. Payment of $597 is due prior to the first coaching appointment. 

If at any point it is the professional opinion of your coach that it is not advantageous for the coaching program to continue, your coach can terminate the coaching agreement. If this happens, you are responsible for the pro-rata share of coaching services received with each session assigned 1/6 of the full cost.


The International Consortium for Health & Wellness Coaching defines Health & Wellness Coaching in the following manner: Health and Wellness Coaches partner with clients seeking self-directed, lasting changes, aligned with their values, which promote health and wellness and, thereby, enhance well-being. In the course of their work health and wellness coaches display unconditional positive regard for their clients and a belief in their capacity for change, and honoring that each client is an expert on his or her life, while ensuring that all interactions are respectful and non-judgmental.

My responsibility as health & wellness coach is to guide, educate, and cheer you on in your experience of discovering your best health. Within my scope of practice, I will help you leverage your strengths and values, foster self-acceptance and self-confidence, and assist you with challenges, setbacks, baby steps, and discoveries on your journey to better health. Your responsibilities as a client include bringing awareness and openness to new experiences, choices and habits; taking control of your own physical, mental and emotional well-being AND decisions, choices and actions; realizing positive change takes time and dedication to become a habit; and most importantly, understanding that honesty and open communication is an absolute necessity for our coaching relationship to flourish.

I want you to keep in mind that the coaching relationship is in no way to be construed as psychological counseling or psychotherapy and that, in the event that you feel the need for professional counseling or therapy, it is your responsibility to seek a licensed professional.

I want to highlight that coaching results are not guaranteed. You are entering into coaching with the understanding that you are responsible for creating your own results.


You can expect me to be straightforward, constructive and confidential. I will regularly ask questions that are intended to increase your success in attaining your health goals. Please be honest with yourself and me throughout the coaching process. You can say anything to me, positive or negative; this includes letting me know if something makes you uncomfortable or if you don't want to respond to a question. Please let me know at any time if you have concerns that we haven’t addressed. I encourage you to take a few minutes before each of our calls to get clear and focused so we can maximize the benefit of our time together (and I promise I will do the same).


Private coaching is conducted for the purpose of educating you on wellness, lifestyle, and health risk reduction/disease risk reduction topics. I do not practice medicine, dispense medical services or medications, diagnose or treat medical conditions. Private coaching should not be relied on to suggest a course of medical treatment for you, which can only be provided by a physician or other qualified medical care provider. Private coaching should not be used as a substitute for or in place of a visit or call to, consultation with, or the advice of your physician. I expect you will consult with your physician before embarking on a new treatment, diet, or fitness program, including those discussed in private coaching. You should never disregard or discontinue following medical advice, delay in seeking it, or modify or discontinue medications because of information, materials, or conversations that occur in the course of private coaching.

Unforeseen technical difficulties including but not limited to internet outages may occur from time to time. I will make every effort to fix the problem to our mutual satisfaction.


I agree not to disclose, reveal, or make use of any Confidential Information learned of through  transactions with you, during discussions and interactions with you, or otherwise, without your written consent unless compelled by law.

I shall keep your Confidential Information in strictest confidence and shall use my best efforts to safeguard your Confidential Information and to protect it against disclosure, misuse, espionage, loss, and theft.

You are aware I will keep notes of coaching sessions to better serve you.  These notes may include topics discussed, goals set, and/or possible future topics for discussion. I will store notes in a secure location.

You will do your part to maintain the security of your personal health information by refraining from posting confidential health information in online comments, communities, and groups associated with Cheat Diabetes and/or your coach and by refraining from using emails and texts to communicate confidential health information. 


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