Consent Form for Transformative Coaching
Sessions
Introduction
This consent form outlines the scope, expectations, and boundaries of Transformative Coaching services provided to Ultra-High-Net-Worth (UHNW) families. By signing this document, you acknowledge that you understand the nature of the coaching relationship and agree to participate voluntarily.
1. Purpose of Transformative Coaching
Transformative Coaching is a forward-focused, collaborative process designed to support personal growth, enhance self-awareness, and promote meaningful change. It is not psychotherapy, counselling, or medical treatment. If you are interested, there is also the option to include Art Therapy, or I can refer you to another specialist if needed.
2. Scope of Services
Sessions may include:
Reflective dialogue – exploring thoughts, emotions, and perspectives
Guided exercises – practical tools to support personal growth
Values exploration – identifying what truly matters to you
Relationship building – Supporting families in strengthening bonds, fostering open and effective communication, and cultivating a positive, connected family environment
Goal-setting and mindset work – creating actionable steps to move forward
Coaching may be provided to individuals, couples, or family units, depending on the agreed arrangement.
Please note: The coach does not provide legal, financial, or medical advice.
3. Confidentiality
All sessions are confidential, except where disclosure is required by law or safeguarding obligations.
Supervision:
The coach may discuss session elements with a qualified supervisor for professional development.
Supervisors review content anonymously—no names or locations are shared; only pronouns are used.
UHNW Considerations:
Households may involve support staff or security personnel. Confidential information will not be disclosed without explicit client consent, except for anonymous supervisory review.
Virtual sessions are conducted securely via encrypted platforms.
Exceptions to confidentiality:
Risk of harm to self or others
Legal obligations to disclose information
Safeguarding concerns, particularly involving minors
4. Working With Minors
Confidentiality is respected within safeguarding boundaries.
Parents/guardians receive general progress updates, not private details unless risk or harm is involved.
Separate guardian consent is required for clients under 18.
5. Client Responsibilities
Clients agree to:
Attend scheduled sessions punctually
Engage openly, honestly, and respectfully
Communicate any concerns or changes in needs
Understand that outcomes depend on their commitment and participation
6. Coach Responsibilities
The coach will:
Provide a safe, supportive, and nonjudgmental environment
Maintain strict professional boundaries
Disclose potential conflicts of interest promptly
Protect client confidentiality at all times
7. Fees, Payment, and Cancellations
Fees for Transformative Coaching are included as part of the chosen package (13, 26, or 52 sessions). Clients can decide how they would like to schedule these sessions.
Clients may choose to include Art Therapy sessions within their package if desired. They can decide whether these sessions occur on the same week as Transformative Coaching, on alternating weeks, or every two weeks, based on their preference.
Clients may also choose to participate in Transformative Coaching only, without Art Therapy sessions.
All sessions within the package are deductible from the full amount, regardless of how they are scheduled.
Sessions must be cancelled or rescheduled with at least 24 hours’ notice.
Sessions cancelled with less notice may be deducted from packages or charged in full.
UHNW-specific arrangements (e.g., travel, extended hours, or privacy accommodations) may incur additional fees.
8. Privacy & Data Protection
Client data is handled in compliance with applicable privacy laws.
Virtual sessions are conducted via Zoom and are not recorded, ensuring confidentiality.
All digital communications, including emails and documents, are stored securely and can be encrypted to ensure confidentiality.
Emails and documents are handled with strict confidentiality encrypted to protect your privacy.
9. Limitations of Coaching
Transformative Coaching is not a substitute for mental health treatment
Clients seeking additional support may be offered Art Therapy sessions or referred to qualified professionals
10. Consent & Agreement
By signing below, the client confirms that:
They understand the nature and boundaries of Transformative Coaching
They participate voluntarily
They consent to the terms outlined in this form
By signing below, the Transformative Coach confirms that:
They will provide services in accordance with ICF ethics and regulations
They will maintain confidentiality, professional boundaries, and conduct consistent with the standards and best practices of Transformative Coaching
Client Name: ___________________________
Signature: ___________________________
Date: ________________________________
Therapist Name: _____________________________________
Signature: ________________________________________
Date: _____________________________________________
Guardian Consent (For Clients Under 18)
I am the parent/legal guardian of the minor named below and consent to their participation in Transformative Coaching sessions.
Minor Name: ___________________________
Guardian Name: _________________________
Date: _________________________________
Therapist Name: _____________________________________
Signature: ________________________________________
Date: _____________________________________________