FRESH Coaching Start Intake Form
  • If you are an EXISTING client (meaning you've had an appointment within the last 9 months) you do NOT need to fill out this form again.

  •  - -
  •  / /
  •  - -
  • Disclaimer: Clifton Brantley's framework for helping people do love and life better is rooted in biblical principles. You do not have to be a Christian to work with Clifton. However, you should be aware that he is not going to change his Christian framework on how to help you.

  • Terms and Conditions

    Please read and submit below...
  • By signing this agreement, you acknowledge that you have read, understand and agree to these terms.

    Description of Services: Coaching is a partnership (defined as an alliance, not a legal business partnership) between the Coach and the Client in a thought-provoking and creative process that inspires the client to maximize personal and relational potential. It is designed to facilitate the creation/development of personal and/or relational goals.

    This is NOT considered therapy. You will not have any medical records on file.

    1. Coach-Client Relationship

    A. As your coach, it is my role to facilitate change in your life. It is NOT my role to tell you what to do. You must use your own discretion in regards to the advice or direction you receive from your coach.

    B. The Client (be it couple or individual) is solely responsible for creating and implementing your own physical, mental and emotional well-being, decisions, choices, actions and results arising out of or resulting from the coaching relationship and his/her coaching calls and interactions with the Coach. As such, the Client agrees that the Coach is not and will not be liable or responsible for any actions or inaction, or for any direct or indirect result of any services provided by the Coach. Client understands coaching is not therapy and does not substitute for therapy if needed, and does not prevent, cure, or treat any mental disorder or medical disease.

    C. The Client further acknowledges that he/she may terminate or discontinue the coaching relationship at any time.

    D. The Client acknowledges that coaching is a comprehensive process that may involve different areas of his or her life, including work, finances, health, relationships, education and recreation. The Client agrees that deciding how to handle these issues, incorporate coaching principles into those areas and implementing choices is exclusively the Client’s responsibility.

    E. Client acknowledges that coaching does not involve the diagnosis or treatment of mental disorders as defined by the American Psychiatric Association and that coaching is not to be used as a substitute for counseling, psychotherapy, psychoanalysis, mental health care, substance abuse treatment, or other relational advice by legal, medical or other qualified professionals and that it is the Client’s exclusive responsibility to seek such independent professional guidance as needed. If Client is currently under the care of a mental health professional, it is recommended that the Client promptly inform the mental health care provider of the nature and extent of the coaching relationship agreed upon by the Client and the Coach.

    F. The Client understands that in order to enhance the coaching relationship, the Client agrees to communicate honestly, be open to feedback and assistance and to create the time and energy to participate fully in the program.

    G. The Client understands that the Coach is not qualified to give legal advice. Any and all advice should be carefully considered by the client. The coach cannot be held liable for misunderstandings that the client may have.

    2. Services

    The parties agree to engage in a the coaching program through virtual and in-person meetings. When meeting virtually, the meeting will be recorded for the client's benefit and reference. When you do not want your sessions recorded, you can request for them not to be.

    3. Refunds

    This coaching agreement is valid as of the date this agreement is signed.

    No refund can be given within 24 hours of your first session. Whether you complete all of the sessions you agreed to or not, the cost is the same.

    YOU MUST SCHEDULE YOUR FIRST SESSION WITHIN 6 WEEKS OF SIGNING UP OR YOU WILL BE TERMINATED AS A CLIENT. YOU WILL BE CHARGED A 40% SERVICE CHARGE WHICH WILL BE TAKEN OUT OF YOUR REFUND.

    If you have a late cancellation you will not be charged an extra fee, however you may lose that session. The Coach reserves the right to use an attorney or collection agency to secure payment.


    If the Coach decides to give a refund, the Client will lose the discount of paying for multiple sessions and will be converted to the current “per session” cost which is $350 per per session/hour.
    If the Client do not complete the sessions in the allotted amount of time the Client will forfeit the remaining sessions and will need to sign up for new sessions to continue. The Coach reserves the right to refuse resigning.


    4. Procedure

    The time of the coaching meetings and/or location will be determined by Coach and Client based on a mutually agreed upon time. The Client will schedule their own meetings using the calendar provided by the Coach.

    4a. Appointment Notifications

    The client is responsible for managing their own client profile. If the client is a couple then either person of the couple can manage the profile. The client is responsible for setting up notifications in their account. When the coach initially sets up the account, it is automatically setup to receive email notifications. The client must add phone notifications with a valid phone number.
    The client is responsible for knowing when their appointment is, regardless of notifications. A “no show” cannot be excused away because the client did not receive a reminder notification.

    5. Cancellation Policy

    Client agrees that it is the Client's responsibility to notify the Coach 24 hours in advance of the scheduled meetings. Coach reserves the right to bill Client for a missed meeting. Coach will attempt in good faith to reschedule the missed meeting. You must be on time for your sessions. If you are later than 10 minutes after the scheduled start time the meeting may be cancelled and you will lose that session.

    6. Termination

    Either the Client or the Coach may terminate this Agreement at any time written notice. The notice can be via email. Client agrees to compensate the Coach for all coaching services rendered through and including the effective date of termination of the coaching relationship.

    7. User Accounts

    You may be required to create an account to access certain features of our services. You are responsible for maintaining the confidentiality of your account and password and for restricting access to your account. You agree to accept responsibility for all activities that occur under your account.

    8. User Conduct

    You agree not to use our services for any unlawful purpose or in any way that violates these Terms and Conditions. You also agree not to:

    Harass, abuse, or harm other users
    Violate the rights of third parties
    Interfere with or disrupt the operation of our services
    Use our services for commercial solicitation without our prior written consent


    9. Intellectual Property

    All content and materials available in our sessions, including but not limited to text, graphics, logos, images, and software, are the property of Brantley & Harris Global, LLC or its licensors and are protected by copyright, trademark, and other intellectual property laws.

    10. Limitation of Liability

    To the fullest extent permitted by law, Brantley & Harris Global, LLC shall not be liable for any direct, indirect, incidental, special, or consequential damages arising out of or in any way connected with the use of our coaching services.

    11. Indemnification

    You agree to indemnify and hold Brantley & Harris Global, LLC, its affiliates, officers, directors, employees, and agents harmless from and against any and all claims, liabilities, damages, losses, or expenses arising out of or in any way connected with your use of our services.

    12. Governing Law

    These Terms and Conditions shall be governed by and construed in accordance with the laws of Texas, without regard to its conflict of law provisions.

    13. Changes to Terms and Conditions

    We reserve the right to update or modify these Terms and Conditions at any time without prior notice. Your continued use of our services after any such changes constitutes your acceptance of the new Terms and Conditions.

     

    14. Entire Agreement

    This document reflects the entire agreement between the Coach and the Client, and reflects a complete understanding of the parties with respect to the subject matter. This Agreement supersedes all prior written and oral representations. The Agreement may not be amended, altered or supplemented except in writing signed by both the Coach and the Client.

    15. Dispute Resolution

    If a dispute arises out of this Agreement that cannot be resolved by mutual consent, the Client and Coach agree to attempt to mediate in good faith for up to 30 days after notice given. If the dispute is not so resolved, and in the event of legal action, the prevailing party shall be entitled to recover attorney’s fees and court costs from the other party.

    16. Severability

    If any provision of this Agreement shall be held to be invalid or unenforceable for any reason, the remaining provisions shall continue to be valid and enforceable. If the Court finds that any provision of this Agreement is invalid or unenforceable, but that by limiting such provision it would become valid and enforceable, then such provision shall be deemed to be written, construed, and enforced as so limited.

    17. Waiver

    The failure of either party to enforce any provision of this Agreement shall not be construed as a waiver or limitation of that party's right to subsequently enforce and compel strict compliance with every provision of this Agreement.

    18. Binding Effect

    This Agreement shall be binding upon the parties hereto and their respective successors and permissible assigns.

  • Payment & Refund Terms

  • No refund can be given after coaching has begun. Late cancellation or no show for the first session is considered the start of coaching.
    If the decision is made to give a refund, you will lose the discount of paying for multiple sessions. The sessions you paid for will be converted to the whatever the current 'per session' cost is.
    If you do not complete your sessions in the allotted amount of time (14 weeks for 6 sessions) you may forfeit your remaining sessions. We do reserve the right to refuse resigning.
    PLEASE UNDERSTAND that you are paying for a service. Whether you complete one session or all of them, the cost of the service is the same.
    I reserve the right to stop working with any client for the following reasons:

    Continuously missing sessions with no notice.
    Client requesting a refund.
    Client becoming disrespectful.
    Client has not paid their remaining balance in the alloted amount of time.

  • In Case Of Divorce

    This is only for those doing couple's work
  • It is my mission to help strengthen relationships and help individuals be the best version of themselves. If you become a client for the purpose of couple’s coaching, please be aware that the COUPLE is the client. This means that the work we do will be to help the couple as a whole primarily.

    If the client decides to divorce or break up, neither of the participants of the relationship can become an individual client until after at least 2 years have passed since your break up.

    If you both later decide that you are not divorcing and want to keep working then you will need to sign a new consent to continue.

    In plain English: I will not take you on as an individual client after we have done couple’s work, unless it is for the purpose of making the relationship better. If you need, I can refer you to a new therapist.

    Please advised that I do NOT testify in court nor do I participate in anyway in divorce or custody proceedings. If I happen to get a subpoena from your lawyer, you will be expected to pay for the professional time required for me to respond. If I am forced to testify or participate in these kind of proceedings in anyway, my fee $350/ hr for a minimum of 3 hours which equals $1050.

  • Powered by Jotform SignClear
  • Should be Empty: