Coaching Client Agreement and Informed Consent

    Disclosure Statement and Agreement for Services Introduction

    This agreement is intended to provide important information to you regarding Parent Coaching Services. Please read the entire document carefully and be sure to ask your Coach any questions you might have regarding its contents.

    Information about your Coach

    Robin McEvoy, Ph.D. holds a Ph.D. in Developmental Neuropsychology with an emphasis on learning and developmental challenges. Dr. McEvoy is a Licensed psychologist (Lic. #1853) in the state of Colorado, USA.

    Cost of Services

    Parent Coaching services are not covered by insurance. Payments are due at the time of your coaching appointment in the form of cash, check, credit card or payment service. For the initial coaching session, I charge $100/hr.

    Confidentiality

    As a licensed psychologist, it is my duty to protect the confidentiality of the communications with my clients, including coaching clients, but there are limited to confidentiality if sessions are not conducted in-office.

    Confidentiality cannot be guaranteed if sessions are conducted via phone or online. Clients should use their own discretion when utilizing these options. There are exceptions to the general rule of legal confidentiality. For example, except in the case of information given to a licensed psychologist, legal confidentiality does not apply in a criminal or delinquency proceeding. Other exceptions include situations in which you may be "serious harm to yourself or others" as in child abuse, suicide or grave disability. Other than the above noted instances, I will provide information regarding an assessment to a third party only with the signed consent of the client or the client's legal guardian.

    About the Coaching Process

    The International Coach Federation’s definition of coaching quoted in part that is as follows: “Professional Coaching is an ongoing professional relationship that helps people produce extraordinary results in their lives, careers, businesses or organizations. Through the process of coaching, clients deepen their learning, improve their performance, and enhance their quality of life. In each meeting, the client chooses the focus of conversation, while the coach listens and contributes observations and questions. This interaction creates clarity and moves the client into action. Coaching accelerates the client’s progress by providing greater focus and awareness of choice. Coaching concentrates on where clients are now and what they are willing to do to get where they want to be. Coaches recognize that results are a matter of the client’s intentions, choices and actions, supported by the coach’s efforts and application of the coaching process.”

    Termination of Coaching

    Coaching with the Child Decoded team is not intended to be a long-term process. It consists of consultation with Dr. McEvoy and Kim Gangwish to help you define direction for next steps. There is also additional consultation with other specialists on the team as desired.

    The length of your coaching and the timing depend on the specifics of your goals.

    Either the coach or client may discontinue coaching at any time.

    Liability

    This agreement is for Coaching, not Psychotherapy. Dr. McEvoy is working only within the capacities of a Coach and will not be held liable for discrepancies. While coaching can provide education about challenges a child may be experiencing, coaching will not address psychological issues such as depression and anxiety or diagnose any learning, developmental and mental health conditions. For issues such as these, seek the medical attention from a Physician or Licensed Mental Health Professional in your area.

    By signing this agreement, you are agreeing that you understand the difference in these two functions and you will get appropriate professional help for mental health issues if necessary.

    Your signature indicates that you have read this agreement for services carefully and understand its contents. Please ask your coach to address any questions or concerns that you have about his information before you sign.

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