Jessica May Jensen | Coaching Agreement

1
Client Name* This field is required.
First Name
Last Name
2
What pronouns do you prefer?He/Him/She/Her/They/Them/Other
3
Email* This field is required.
example@example.com
4
Phone Number
Area Code
Phone Number
5
Birthday
Date
Month
Day
Year
6
Why are you interested in coaching?* This field is required.Choose as many options as you like
Finding my life purpose
Personal transformation
Goal setting
Finding out who I am and stepping into a more authentic version of myself
Gaining clarity around what I really want for myself
Shifting my mindset and unblock limiting beliefs
Pushing through fear to achieve a vision
Feeling more supported, validated and encouraged
Stepping into a new chapter after a life changing event
Guidance through spiritual ascension or dark night of the soul
Intuitive guidance (tarot readings)
Neurodivergent support including flexible structure, planning and execution
Healing my inner child
Supporting my creativity
Other
7
Tell me a bit more about your goals for our session/s:What would you like to focus on? How would you like to feel after a session? You can also ask me any questions you might have here.
Huge
Large
Normal
Small
Ok
Ok
8
Cultural ConsiderationsIs there anything that feels important for me to know about who you are, the sociocultural situations relevant to you, or anything that may be helpful for me to know in order to make your care as supportive as possible? This might include: Race/Ethnicity, Gender Identity, Sexual Orientation, Disability or Chronic Illness, etc.
Huge
Large
Normal
Small
Ok
Ok
9
CLIENT RESPONSIBILITIES

1. As a client, I understand and agree that I am fully responsible for my own physical, mental and emotional well-being, actions and results during my coaching sessions including my choices and decisions. I am aware that I can choose to discontinue coaching at any time. I recognize that coaching is not psychotherapy, does not prevent, cure, or treat any mental disorder or medical disease.

2. As the Client, I understand and agree that the Coach is not and will not be liable for any actions or inaction, or for any direct or indirect result of any services provided by the Coach.

3. I understand that the Coaching relationship I have with my coach is designed to facilitate the creation/development of personal, spiritual and/or professional goals and to develop and carry out a strategy/plan for achieving those goals.

4. I understand that information will be held as confidential unless I state otherwise, in writing, except as required by law.

5. I understand that Life Coaching is not used in lieu of professional advice. I will seek professional guidance for legal, medical, financial, business, spiritual, psychological or other matters. I understand that all decisions in these areas are exclusively mine and I acknowledge that my decisions and my actions regarding them are my responsibility.

SERVICES

This agreement, between Jessica May Jensen and client, will begin on date signed and will continue for up to twelve weeks from date of first session, dependant on the selected coaching package, or until terminated by Client or Jessica May Jensen. Coach will be available to Client by scheduled meetings or email as defined by the Coach.

SCHEDULE AND FEES

The coaching fee is payable to confirm the coaching session booked by the Client. If payment is not received, the booked time may be forfeited. If Client must cancel and provides at least 24 hours notice, the Client may reschedule to another available time or day. If client needs to cancel within 24 hours of the scheduled start time, the session may be forfeited.
10
Please check the box to show you understand and agree to the following statements* This field is required.
I understand that coaching is not, and is not a replacement for, psychotherapy or licensed medical services.
I understand that coaching is not, and is not a replacement for, professional advice in relation to financial, legal or medical matters.
I understand it is my responsibility to schedule my sessions online using the link provided by Jessica May Jensen.
I understand that payment is due in full to confirm my coaching session/s.
If I need to reschedule a session, I will give at least 24 hours notice.
If I cancel within 24 hours of a booked session, I understand I may forfeit the session.
11
Client Signature* This field is required.
Clear
12
Date Signed* This field is required.
Date
Month
Day
Year
13
Coaching Services* This field is required.Select one of the four coaching and package options...
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Mini Coaching Session1 x 30 minute coaching session. Book as-needed. Purpose, goals and growth.
$85.00Edit
Back
Full Coaching Session1 x Full coaching session. Book as-needed. Purpose, goals and growth.
$150.00Edit
Back
6 Week Coaching Package6 x Full coaching sessions plus self development exercises and workbook.
$800.00Edit
Back
12 Week Total Transformation12 x Full coaching sessions plus self development exercises and workbook.
$1,500.00Edit
Back
Total cost $0.00
First Name
Last Name
Should be Empty: