I understand that all information I entered in this form will be considered strictly confidential.
The data gathered from this form will only be used as a basis for the type of coaching the client will need.
I understand that in order to be successful, it is vital to follow the plan agreed by both the life coach and the client.
If I am working with a psychotherapist (which is disclosed above), I will inform them that I am working with Janette R. Smith.
I understand that my work with my coach is not therapeutically based. I understand, and agree, that Janette R. Smith does not represent herself as anything other than a trained and certified Strategic Intervention coach.
I understand that all comments and ideas offered by my coach are solely for the purpose of aiding me in achieving my defined goals. I have the ability to give my informed consent, and hereby give such consent to my coach to assist me in achieving such goals.
I hereby release, waive, acquit and forever discharge Janette R. Smith and Janette R. Smith Coaching, their agents, successors, assigns, personal representatives, executors, heirs, and employees from every claim, suit action, demand, or right to compensation for damages.