Resolution to Reality Coaching Agreement

This document constitutes a contract between us. Read it carefully and raise any questions or concerns before submitting your agreement form and payment.

This agreement is between Valerie Silver as Coach and Client named on the agreement form below.

Initial Term: 12 weeks beginning the week of February 5, 2012 until the end of April, 2012.__

Fee: $127 paid in full before first session via PayPal, cashiers check or money order. This fee reflects payment for the first month of coaching. A full scholarship covers months two and three.

Session Delivery: Date and time to be determined. Schedule via the online scheduler is available to active clients.

Delivery of Coaching Services:

• During our initial session we will overview how coaching works, review our Coaching Agreement, and discuss how we will partner together. We will discuss your coaching goals, agree on how we will measure progress and results, and discuss how you are best coached.

• Coaching sessions are 30-45 minutes long via telephone or skype. Sessions will occur as scheduled. You, the Client, are responsible for calling me, the Coach, to initiate your session (unless otherwise agreed). Please be as prompt as possible. Sessions initiated late will still end at the pre-arranged time.

• Coaching includes unlimited email and brief phone contact between sessions as needed during the coaching period. Please call or email me between our regularly scheduled sessions if you need feedback, have a question, or can’t wait to share a success. Do leave a message and a request for a call back if needed. I will do my best to return all messages within a business day. Please keep extra calls to a maximum of 10 minutes.

• Periodic reviews of our coaching partnership will be conducted. At the end of the 12 week period, we will evaluate your progress and results. If both parties determine to continue the coaching services, this agreement will extend for another 3 months for the agreed upon monthly retainer.

Cancellations:

• Coach and Client agree to give at least 8 hours prior notice via phone, email, or the on-line scheduler if an appointment must be changed. The client understands that if notice is not given, the appointment will be forfeited with no reimbursement.

• In cases when advanced notice isn’t possible (ie: sudden extreme illness or serious accident to self or family member) your session may be rescheduled.

Confidentiality:

• Val promises that all information shared will be kept strictly confidential. Nothing regarding your coaching will be shared without your expressed permission, except in those situations where such confidentiality would violate the law or cause hurt or harm, or if I am required to do so by a court order. Our mutual trust of each other is paramount in this relationship.

  You agree that Val may list your name, email and number of coaching hours on a tracking sheet for ICF certification purposes.

• Client understands that certain topics may be anonymously and hypothetically shared with other coaching professionals for training OR consultation processes.

• The Coach will not use Client as a reference without first obtaining verbal or written consent. Coach will request a written testimonial for public viewing prior to your program completion. You are under no obligation to do so.

• When coaching is at its finest, intellectual property is generated both ways. Coach and Client agree to protect each other’s intellectual property rights. In order to honor and protect my intellectual property, you agree not to disclose or communicate specific information about my practice, materials or methods to any third party.

Nature of Coaching Relationship and Guidelines:

• Coaching is for people who are basically well-adjusted, emotionally healthy, and wanting to make changes in their lives. Coaching is primarily about dealing with current challenges and looking ahead. Your success will depend on your willingness to define goals, take risks, and try new approaches. Like any human endeavor, coaching can involve feelings of distress and frustration that often accompany the process of change. Coaching is an ongoing relationship that may take one month, several months, or many months. Coaching does not offer any guarantee of success.

• Coaching has been demonstrated to have very powerful results when there is a strong desire to develop potential, a gap where the client is presently and the level he/she wants to achieve, and willingness to take action to achieve results desired. With these elements present, Client can take steps to improve his/her results and create a more successful life.

• Coaching is not advice, therapy, or counseling. It is a relationship of equals where accountability for moving forward lies with Client and responsibility for providing insightful and challenging coaching to support desired outcomes lies with the Coach. Issues could include, but not be limited to personal growth and wellness, relationship enhancement, spiritual growth, lifestyle management and balance, decision making, and achieving short-term goals, and many other agreed upon topics.

• Client understands that coaching does not involve the diagnosis or treatment of mental disorders as defined by the American Psychiatric Association. Client understands that coaching is not a substitute for mental health care or substance abuse treatment and will not use it in place of any form of diagnosis, treatment or therapy.

• Client promises that if he/she is currently under the care of a mental health professional, that she/he has consulted with his/her mental health provider regarding the advisability of working with a coach and that this person is aware of his/her decision to proceed with the coaching relationship. Client agrees to make Coach aware of any mental health services she/he receives. If either of us recognizes that Client has a problem that would benefit from psychotherapy, Client agrees to seek appropriate support. In some situations, Coach may insist that Client enter psychotherapy and that Coach has access to that psychotherapist, as a condition of continuing as your Coach.

• Coach will interact with Client by asking tough questions, acknowledging wins, fostering discovery, giving feedback, having a respectful 'edge' to encourage you out of comfort zone into stretch and development areas. Coaching may involve brainstorming, values clarification, home play, goal-setting, identifying plans of action, accountability, agreements to change behavior, assessments, self-improvement tools, and examining choices and lifestyles.

• Client understands that coaching is not a substitute for professional advice by legal, medical, financial, business, spiritual or other qualified professionals. Client agrees that all decisions in these areas are exclusively hers/his and acknowledges that his/her decisions and actions regarding them are her/his sole responsibility. Coach is not responsible for any actions taken or results created from our coaching, although Coach is looking forward to many successes and accomplishments.

• Coach will ask Client to keep her informed as to what is needed to keep her/him moving forward in our coaching process. If at any time Client believes the coaching service Coach provides is not meeting her/his expectations, Coach requests he/she take the initiative to let her know right away. Together we will review the coaching process and make adjustments as necessary to further goal progress.

• For information on the International Coach Federation standards and practices for coaching, please go to http://www.coachfederation.org

• Coaching is most effective when all parties are honest and straightforward in their communication. Think about this right now, and decide if you are willing to be honest with yourself and your coach, and you can give Coach full permission to be bold and forthright in all our interactions.

• Taking 100% Personal Responsibility and taking intentional, committed action steps are essential to achieving your coaching goals. Reflect right now to confirm whether you are absolutely certain you are ready to begin taking new opportunities and making new choices so changes in your life can happen NOW.

Termination:

• Either party may end the coaching relationship by providing the other party with a one-week written notice, which may be transmitted by email.
• Your full payment will be cheerfully refunded should you notify me and opt out prior to your second scheduled session.
• A full refund will be granted if either of us express concerns about continuing the program in writing (via email) prior to your second scheduled session and we mutually agree to coach around these concerns during that session before making a final decision.
• No refunds, partial or full, will be granted for termination following the second scheduled session.

Consumer Satisfaction and Legal Remedies:

• I trust that you are satisfied with the coaching services that I provide you and that you experience improvements and positive changes in your life. Because of the complexity of human functioning, I cannot guarantee the outcome of the coaching, nor the impact on your life of any changes that you subsequently make.

• Each party agrees to indemnify, defend and hold harmless the other party, its agents, officers, and employees from and against any and all liability expenses including any defense costs and legal fees incurred in connection with claims for damages of any nature whatsoever, including but not limited to bodily injury, death, personal injury or property damage arriving from such party’s performance or failure to perform its obligations hereunder.

• Because coaching by telephone may occur across state lines this agreement shall be governed by and enforced in accordance with the internal laws of the State of New York.

Please complete the brief form below to acknowledge this coaching agreement. Do make a copy of this agreement for your records.

Payment and Scheduling

To pay via PayPal using my secure merchant account, do so here. You do not need a PayPal account to make this payment.

Be sure to complete the agreement form below before leaving this page.

Once I receive your agreement form and your payment, I will email you with the link to the online scheduler. Or if you prefer, I will call you to set up your schedule via telephone.

Resolution to Reality Coaching Agreement Please note that all fields followed by an asterisk must be filled in. Please check each box below You must be able to honestly check each box to enter into this coaching agreement.* Please check each box below You must be able to honestly check each box to enter into this coaching agreement.* I am motivated and committed to taking action on my determined personal goals. I realize that anything less than my intentional participation will not result in progress. I accept full responsibility for myself and any actions I take that might result from Coaching. I am not receiving undisclosed mental health services. I am not addicted to alcohol or any drugs. I have read and agree with the Coaching Guidelines and the Coaching Agreement. Scheduling* Scheduling* Send the link to the online scheduler. Please call me to set up my first appointment. Best time to call in the evenings or weekend: First Name* First Name* Last Name* Last Name* E-mail Address* E-mail Address* Street Address* Street Address* City* City* State/Prov* State/Prov* Zip/Postal Code* Zip/Postal Code* Country* Country* Country United States Canada ---------------- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribadi North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Federated States of Micronesia Moldova Monaco Mongolia Monserrat Morocco Montenegro Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda S. Georgia and S. Sandwich Isls. Saint Kitts and Nevis Saint Lucia Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Minor Outlying Islands Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam US VIrgin Islands Wallis and Futuna Islands Western Sahara Yemen Yugoslavia (former) Zaire Zambia Zimbabwe Home Phone* Home Phone* Please enter the word that you see below.

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