• COACHING AGREEMENT

    Please fill out and submit this Coaching Agreement at least 24 hours before your intake session. The results will be sent to me immediately after you hit the submit button at the bottom of the page.
  • THE COACH’S COMMITMENT

    • Kim Collins, referred to in this Agreement as the Coach, will provide Coaching / Consulting services under the company name: Organized Kaos.
    • Kim Collins will provide Coaching / Consulting that is a professional client relationship designed to facilitate the creation and development of personal, professional or business goals and to develop and carry out a strategy/plan for moving towards those goals.

    YOUR COMMITMENT

    • I agree to pay all Fees as stated in this Agreement.
    • I agree to call or meet the Coach at my scheduled times.
    • I agree to be honest and open with myself and my Coach.
    • I am committed to change and agree to take responsibility for my life, choices and actions.
    • I agree to be physically and mentally prepared for all sessions.
    • I understand that I am responsible for using all the time I have scheduled.

    COACHING

    • I enter into this Agreement with the full understanding that I am solely responsible for creating my own results. I understand that success in meeting my goals (in whole or part) cannot be guaranteed and no warranties are given.
    • I am aware that Coaching / Consulting is not counselling, psychotherapy, psychoanalysis or any other form of mental health care treatment or therapy, nor is it to be used as a substitute for professional advice by legal, medical, financial, business or other qualified professionals. If appropriate, I will seek independent professional guidance in these areas.
      I understand that all decisions and actions are my sole responsibility.

    ETHICS & CONFIDENTIALITY

    • The Coach will not use or disclose the information shared with them during sessions, unless expressly authorized in writing.

    ADMIN

    • All sessions must be paid in advance.
    • Invoices must be paid immediately upon receipt or the next scheduled appointment can not be confirmed.
    • Where it is necessary for either the client or the Coach to cancel or reschedule a session, this may be done by phone, text, email or within the scheduling system.
    • Cancellations and reschedules must be made by 11:59pm Eastern Time before the scheduled session.
    • All sessions will be charged for the ENTIRE missed session if it is not cancelled or rescheduled in accordance with this agreement.
    • All sessions will end at the scheduled time regardless of late arrivals.

    FEES & REFUNDS

    I agree to pay Kim Collins according to the current fee schedule outlined:

    • Intake (Phone) = $120 (Office) = $150
    • 60 Min Phone Session = $110
    • 30 Min Phone Session = $55
    • 15 Min Phone session = $28

    I understand and agree that all sales are final. Refunds will not be given. You have up to 12 months from your last appointment to use any unused coaching sessions you’ve already paid for.

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  • *THIS FORM IS HIPPA COMPLIANT

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