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  • Annie Baxter MPCC-Provisional CPCA - Mount Willow Holistic Coaching and counselling mounwillowplace@gmail.com www.mountwillow.com

  • Coaching Intake Form

  • Coaching is person-centered, intuitive, and deeply respectful of your innate wisdom and resourcefulness.

    I create a calm, reflective space where insights emerge organically, rather than following a fixed program. I may bring in solution-focused guidance and practical next steps when helpful, always aligned with your readiness.

    I also integrate gentle somatic and energy-based practices such as EFT tapping, sound healing, and mindful breathwork to support emotional release and grounding. Other Holisitic modalities can be added during sessions such as Access bars or energy work.

    Women, Youth, Teens & Families

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  • Adults (18+): 50 min - $110 per session Youth (<18): 45 min - $90 per session

  • Single Session - Adult $125 / Youth k-5 $60 / 12 + $90 / Family $135

    Monthly Coaching Block - Adult $650 / Youth $360 (4 sessions, including ongoing support and check ins between sessions) Or three month package saving $200 for $1750.

    Book in for a FREE 15 minute consult

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    1. What are your top 3 goals for coaching?

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    Client Consent Statement:
    By submitting this form, I acknowledge that I have been informed about the possibility that the International Coaching Federation (ICF) may contact me to verify coaching hours and the nature of my coaching relationship with Annie Baxter. I understand that:

    The ICF will only confirm coaching hours and the duration of the coaching relationship.
    No personal coaching details will be requested.
    All information provided will be kept confidential and used solely for ICF credentialing purposes.
    My participation is voluntary, and I may choose not to provide consent without any impact on my coaching relationship.
    By selecting signing below, I provide permission for my contact information to be shared with the ICF if requested.

    Policies & Consent - Coaching is not therapy, and results depend on client participation. - Confidentiality: Sessions are confidential except in cases of: 1. Risk of harm to self or others 2. Abuse or neglect of a minor or vulnerable person 3. Legal requirements to disclose information 

    Family Coaching & Consent Information

    Family coaching is a collaborative process designed to support families in improving communication, strengthening relationships, and navigating challenges together. Our coaching sessions provide a safe, non-judgmental space for all family members to explore goals, identify strategies, and develop practical skills for positive change.

    Consent:
    By participating in family coaching, you acknowledge that the sessions are intended for guidance, support, and skill-building, not as a substitute for professional therapy, medical advice, or legal consultation. All information shared in sessions will remain confidential, except where disclosure is required by law (e.g., risk of harm to self or others, abuse). Participation is voluntary, and any family member may withdraw consent at any time.

    By signing below, you confirm that you have read and understood this information and agree to participate in family coaching under these terms.

    Online Coaching Privacy:
    While every effort is made to protect your privacy, online communication cannot be guaranteed to be 100% secure. All communication between sessions will occur via email or phone call.

    No Guarantees:
    Coaching does not guarantee specific outcomes. Success depends on your active participation and follow-through.

    Cancellation Policy:

    Sessions require at least 24 hours’ notice to cancel or reschedule.
    Late cancellations or missed sessions will be charged in full.

    Coaching Services & Consent:
    Coaching supports individuals, teens, and families in reaching goals, improving communication, and developing practical strategies. It is not therapy, medical, or legal advice. Sessions are confidential, except where disclosure is required by law (e.g., risk of harm, abuse, or safeguarding concerns).

    UK Clients:
    Services are provided from Canada. UK clients acknowledge that local laws, including safeguarding requirements, may apply. Sessions are scheduled in Your Time Zone, and fees are payable in your currency,via PayPal or bank transfer through Wise. Participation is voluntary and can be withdrawn at any time.

    By signing, you confirm you have read, understood, and consent to participate under these terms.

     

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  • Annie Baxter MPCC provisional / Insight Coach Practitioner ICP, ICF accredited/ Mount Willow Holistic Coaching and counselling mounwillowplace@gmail.com www.mountwillow.com

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