Cape Cod Caregiver Coach Client Agreement:  

NAME:________________________________________________Date:______________

Please request a copy or print this agreement, sign and date below, and return via email: Melissa@CapeCodCaregiverCoach.com

1. I understand and agree that I am fully responsible for my physical, mental and emotional wellbeing during my sessions, including my choices and decisions. I am aware that I can choose to discontinue services at any time. 

2. I understand that this is a Professional-Client relationship that is designed to support the development of personal, professional or business goals and to develop and carry out a plan for achieving those goals.  

3. I understand that coaching may address multiple areas of my life, including work, finances, health, relationships, education, and recreation. I acknowledge that how I apply coaching insights and make decisions in these areas is solely my responsibility.

4. I understand that coaching does not involve the diagnosis or treatment of mental health disorders. I understand that coaching is not a substitute for counseling, psychotherapy, mental health care or substance use treatment and I will not use it in place of any form of diagnosis, treatment or therapy.  If I am currently receiving mental health services, I confirm that my providers are aware I am also participating in coaching.

5.  I understand that my information is confidential unless I state otherwise in writing, except as required by law. 

6. I understand and consent to the use of AI-assisted notetaking and/or recording during audio calls and/or Zoom sessions are for documentation purposes and will be handled in accordance with confidentiality standards.

7. I understand that coaching topics may be discussed anonymously and hypothetically with other professionals for consultation, supervision, or training purposes, with no identifying information shared.

8. I understand that coaching is not a substitute for professional advice from legal, medical, financial, business, or other qualified professionals. I agree to seek appropriate professional guidance as needed and acknowledge that all decisions and actions remain my sole responsibility.

9. I understand that my coach is available via Melissa@CapeCodCaregiverCoach.com email only if outside of scheduled sessions and that emails will be responded to during normal business hours. My coach is not on call or available for emergency or crisis support. In the event of an emergency, I will contact 911, go to the nearest emergency room or urgent care, and/or contact my primary care provider.

Payment and Scheduling Policy: 

The fee is $150 per 60-minute session. Sessions are scheduled for 60 minutes and should not exceed this time. If additional time or support is needed, additional sessions may be scheduled and will be charged the hourly rate. 

Clients are expected to join sessions at the scheduled date and time. A calendar invitation or email with the Zoom meeting link will be sent in advance. If a client does not attend a scheduled session (“no show”) or does not cancel at least 24 hours in advance, the full session fee will apply and remains the client’s responsibility. 

Payment is expected within seven (7) days of the session. Balances not paid within this timeframe may incur a late fee of $10 per week on the outstanding balance until paid in full. Failure to submit payment may result in suspension of future sessions until the account is brought current.

Payments can be made at:  https://buy.stripe.com/CapeCodCaregiverCoach

By signing below, I understand and agree to the terms above, and acknowledge receipt of the Privacy Policy.

Client Signature__________________________________________  Date____________