Executive Function Coaching - Life Coaching Services Individual Client Agreement

THIS FORM MUST BE SIGNED AND RETURNED BEFORE STARTING SERVICES - READ IN FULL PLEASE

***GrowNOW ADHD services never have any commitments - cancel anytime!***

This form covers and fully pertains to GrowNOW ADHD, LLC and all of its connected LLC's via partnership and/or liscening: EF Camp, LLC, GrowNOW New York (NY) , Los Angeles (CA), Raleigh (NC), Lancaster (PA).

This Agreement is made and entered into on this day: 

For good and valuable consideration, Client is electing to work with Company in connection with Executive Function Coaching (hereinafter "Services" In exchange, Company agrees to provide the services outlined in the Service Details below, utilizing suitable methodologies in accordance with Client's needs, and in accordance with Company's extensive training.

1. Service Details

1. The purpose of Coaching is to provide objectively "healthy" individuals with guidance, accountability, education, and support in order to pursue and achieve their desired goals. Company's Services are specifically designed to coach executive function skills
2. Client confirms he/she has read the entirety of the HIPAA & Policies Packet asked Company any and all necessary questions, and conducted any research necessary to feel he/ she understands what is (and isn't) being provided in Program.
3. If Company will be providing coaching services to a minor, this agreement shall be entered into between Company and the minor child's parent or legal guardian (who shall be referred to herein as the Client) for the benefit of the minor child.
4. Program is not to be considered a substitute for therapy, counseling services, or other medical wellness or treatment. While Company is a licensed speech language pathologist, occupational therapist, etc. Program does not include any therapy or counseling services, and is not designed to treat any mental, emotional, or other medical conditions. If you as the Client believe you may be in need of therapy or counseling, Program is not right for you. By completing this Agreement, you confirm you are not looking for counseling or therapy-related services, understand the difference between Coaching and counseling, and do not expect Company to provide any services other than Executive Function Coaching and Parent Coaching. No therapy or medically-based service will be provided.

2. Confidentiality/HIPAA

1. Company respects each client's privacy, and will not reveal anything said by Client in Coaching sessions without prior written consent from Client, other than in the following scenarios: Suspected abuse to another individual or self, due to a fee or contractual dispute, unintentional breach due to electronic or online communication (including but not limited to e-mail, Facebook messenger, Instagram direct messaging, WhatsApp or other electronic means of communication), and phone. Virtual sessions are never recorded under any circumstances.
2. This Agreement is considered a mutual non-disclosure agreement, meaning both Client and Company agree not to disclose, reveal, or make use of any confidential information learned by either party during discussions, Coaching sessions, calls, emails, or otherwise.
3. If any services within Program include sessions via phone, Zoom, Google Meet, Skype, or any other form of online video or audio session, Client understands the risks and potential consequences of such sessions, including but not limited to the possibility that the transmission of information could be distorted, interrupted, or accessed by unauthorized persons. Client gives his/her informed consent to engage in phone or online video sessions as part of his/her Coaching package.
4. As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information. GrowNOW ADHD cannot disclose my health information other than as specified in the notice. Please use this link to learn more: https://www.hhs.gov/hipaa/for-individuals/index.html

3. Intellectual Property Rights

1. Client agrees and understands that Company has created numerous original, creative works in connection with the Program, and agrees that Company maintains all copyrights and other intellectual property rights in all original or derivative content associated with or included in the Program, whether created prior to working with Client or specifically for Client, including but not limited to: documents, charts, emails, graphs, products, systems, processes, handouts, worksheets, tutorial videos, trade secrets, marketing strategies, Facebook ad strategies, guides, and any other original work created by Company. Client agrees she may be granted a limited right to use selected materials in the course of his or her own business but understands that the rights remain with Company. Nothing in this Agreement shall constitute a transfer of ownership of any Intellectual Property from Company to Client, nor grant any license to use the information, other than that which is expressly provided throughout the course of the Program.
2. Client agrees and understands he/she is not to copy, repost, alter, publish, sell, assist others in selling, manipulate, distribute, or in any way exploit any of the content or intellectual property provided by Company or obtained through working with Company, without Company's express written consent. If such behavior is discovered or suspected, Company reserves the right to immediately end your participation in the Program without refund, as well as access to any program or materials you may have purchased, without refund, and reserve the right to prosecute any actionable infringement or misuse to the full extent of the law.
3. Licensee Rights: Company's Limited License to Client: Client understands that in purchasing the Program, she/he is gaining access to view all content and information available as part of the Program, as well as any additional information or content shared with him/her by Company as she sees fit. Client understands this means he/she will have been granted a limited, revocable, non-transferrable license to read and use the information provided for use in his/her business and life, as instructed or allowed by Company. As a “Licensee,” Client understands and agrees that Client will not: (a) Copy, edit, distribute, duplicate or steal any information or any Content obtained through Program without written permission by Company; (b) post, distribute, copy, steal or otherwise use any portion of the Program or its content without written permission by Company, and understand that any such use may constitute infringement, which may give rise to a cause of action against Client, (c) share purchased materials, information, content with others who have not purchased them.

4. Payment

1. Client agrees to render payment in the amount of $150 per 60-minute session, via credit card, bank transfer, etc. as outlined by Company, and understands that the full purchase amount is due and payable upon receipt of invoice. Client agrees that he/she must complete payment in full before becoming entitled to any products or services included within Program.

5. Indemnification

1. Client agrees at all times to defend, fully indemnify and hold Company and any affiliates, agents, team members or other party associated with Company harmless from any causes of action, damages, losses, costs, expenses incurred as a result of Client’s use of Program, as well as any third-party claims of any kind (including attorney’s fees) arising from his/her actions as a direct or indirect result of Client’s participation in Program. Should Company be required to defend itself in any action directly or indirectly involving Client, or an action where we decide Client’s participation or assistance would benefit Company’s defense, Client agrees to participate and provide any evidence, documents, testimony, or other information deemed useful by Company, free of charge.

6. Medical Disclaimer – Not Medical or Professional Advice

1. Client understands and agree that while Company is a licensed speech language pathologist and has been trained and educated to provide such licensed services, Program offers Coaching services only, separate and apart from Company’s professional practice. There are no counseling or therapy-based elements to Program and is not meant for those who are in need of (or think they may be in need of) speech language services. Client’s enrollment into Program does not make him/her Company’s patient, and no therapist-patient relationship is being formed. Company is not attempting nor suggesting Client enroll in Program in place of a personalized consultation with a licensed speech language pathologist in your geographical area. Program is not intended to be a substitute for medical treatment or therapy/counseling, nor is Program designed to provide Client with a medical diagnosis, treatment, or other medical services.
2. Company encourages Client to consult a physician and/or a licensed therapist if he/she suspects he/she may benefit from such services. We will assume that all individuals choosing to purchase Program will have previously obtained clearance and permission from their applicable personal medical physician or therapist and has concluded that the Coaching Program offered is right for them. Nothing contained within Program is intended to diagnose, cure, treat, or prevent any medical condition or disease, nor is it to be considered medical advice in any capacity.
3. All of GrowNOW services are non-medical and do not involve the use of a professional license. These are coaching services, not therapy, counseling, mental health, social work, speech-language pathology, occupational therapy, social work, psychology, etc. These services are 100% non-medical and do not go through insurance. Health Savings Accounts cannot be used to pay for GrowNOW Services as they are non-medical. 

7. Discontinuation of Program

1. If at any point during Program, Company believes Client to be in need of therapy treatment or other counseling services, Company will advise Client of this, and offer to provide a referral to a licensed professional, if Company knows of one in Client’s geographical area. Client has the right to refuse this referral and ignore the recommendation; however, Client may be asked to discontinue use of Program for his/own well-being, until such treatment can be provided. Should Client wish to disregard Company’s recommendation and wish to continue with Program, Client agrees to sign an additional waiver confirming this information. If Client has not completed Program at the time of discontinuation, any decisions regarding partial refunds are the sole decision of Company and may or may not be offered.

8. Voluntary Participation

1. Client understands and agrees that he/she is voluntarily choosing to enroll in Program and is solely responsible for any outcomes or results. While Company believes in her services and that Program is able to help many people, Client acknowledges and agrees that Company is not responsible nor liable to Client should Client sustain any injuries, incur harm, or encounter any negative ramifications. Client agrees that he/she is fully responsible for his/her health and well-being, including participation in Program and any results therein.

9. Disclaimer / No Guarantees

1. Client understands that results are not guaranteed. While many of Company’s past and current clients have experienced wonderful benefits from the Program, and Company and his/her team will act in their full capacity to ensure all clients are successful and happy in the Program, Company cannot guarantee results of the Program, and cannot make any representations or guarantees regarding individual results. Client will hold Company and Program harmless if he or she does not experience the desired results.
2. Client understands that all services provided by Company in connection with the Program being purchased are provided on an “as is” basis, meaning it is without any guarantees, representations, or warranties, including but not limited to warranties relating to quality, non-infringement, fitness for a particular purpose, merchantability, or expectation or course of performance. Client is choosing to purchase this Program and work with Company on a purely voluntary basis and does not hold Company or Program responsible should Client become dissatisfied with any portion of the Program.
3. Client agrees that he/she does not have a cause of action, legal remedy, and is not entitled to a refund should he/she not achieve the results desired following completion of Program, as long as Company delivers the Program as described herein, or similar substitutes, upon additional agreement by Company and Client.
4. Client agrees to hold Company harmless should any physical, emotional, or financial injury occur as a direct or indirect result of the Program. The content provided by Company on his/her website and within the Program is comprised of information that has worked for Company and other clients, and may or may not be useful to Client in his/her personal business or life. Client understands Company cannot guarantee results from this Program, and has no expectation of a specific result that he or she holds Company responsible for.

10. Dispute Resolution

1. Should a dispute arise between Company and Client, the parties agree to attempt to resolve by good-faith negotiations and discussions. (Client agrees that failure to see results is not a basis for a “dispute” and agrees he or she does not hold Company responsible for any specific results, or those results which have been achieved by other clients of Company.) If unable to reach a resolution informally, Client and Company agree that all disputes will be submitted for Arbitration by the American Arbitration Association, to be completed within a reasonable amount of time. Client and Company agree to participate in the arbitration process in good faith and in a manner that will effectively and efficiently resolve the dispute at hand, including the exchange of any materials, documents, or information. The decision made by the arbitrator is to be final and binding on both parties, and is not to be appealed or otherwise set aside. It is to be enforceable in any court of proper jurisdiction as a judgement of law or decree.

11. Applicable Law

1. This Agreement shall be governed by and under control of the laws of Pennsylvania regardless of conflict of law principles, and regardless of location of Client. Client understands this and agrees that the laws of Pennsylvania are to be applicable here.

12. Amendments

1. This agreement is not to be altered, amended, changed, extended, or considered waived without execution of an additional addendum signed by both Client and Company, or a party authorized to sign on behalf of either party.
   
   Client and Company agree this Agreement constitutes the entire agreement between Company and Client, taking place of and superseding any and all prior agreements, discussions, correspondence, or proposals between parties. Client understands that if a portion of the Program or an expectation is not included in this Agreement, it does not apply and is not included within the Program. Client has taken any necessary measures to discuss further and have any questions answered by Company or Company’s team and is in full agreement with the terms outlined herein. By signing below, Client is confirming he/she voluntarily gives his/her informed consent to receive Coaching services from Company and agree to abide by the terms and conditions outlined herein in this Agreement.

 

Service I am choosing to pursue:

Executive Function Coaching/Life Coaching/Parent Coaching: a 100% non-medical/non-therapy/non-licensed service       

Key Details Below - MUST READ IN FULL.

The info below is very important.

Do Not Skip Over 

The idea of having your child simply work with a coach one-on-one for a few hours per week to improve these skills is not realistic.

A coach alone is not going to “fix” your child and make the stress and issues disappear. If you think a coach can "fix" your child for you, please do not pursue these services.

Parent coaching is the #1 recommendation for a reason. Research shows that progress comes from parent style changes and consistent follow through on coaching recommendations. This program will most likely begin with several Parent Coaching only sessions (depending on specific needs)

1) Private Pay Only - Coaching is not therapy, counseling, or mental health. It is non-medical and not covered by insurance and not reimbursable. No medical codes exist for coaching.

2) Invoices Sent Weekly - Invoices for completed sessions are emailed every Sunday/Monday - AFTER the session takes place.

3) Session Rate - $150 per hour ($40 for each additional 15-minutes) Billing for Communication - all calls, emails, and meetings outside sessions are billed at the same rate and must be scheduled via Calendly.

4) Session Structure
One 60-minute session per week -$150
NEVER any contracts/commitments. Take it week by week, all based on progress.
If your child refuses the session, a parent coaching session is required instead.

5) Cancellations & Late Fees Less than 24-hour notice or no-show - Full $150 fee is charged, and services are paused until paid. We MUST have written documentation via email that was received by your coach more than 24 hours from the scheduled session. If this is not recieved, you wil recieve a non-waivable late charge. You can attempt to reschedule with your coach, but if it does not work with the coach's schedule, the late fee will still stand. Sessions are paused until paid in full - do not e-mail us asking to waive the cancellation charge - it is 100% non-waivable. 

6) Late Payment - Invoices must be paid within 7 days, or a $25 non-waivable late fee applies, and sessions pause until resolved.

7) Coaching Nature & Expectations: This is NOT therapy or medical treatment. It is executive function/life coaching and parent coaching. 

8) Ethics - No guarantees of progress: No timeline provided to expect "results". Parent involvement is essential. Parent coaching is the top recommendation for ADHD support. Meeting with a coach alone will not "fix" your child. You want your child to be able to do hard things - YOU will have to do hard things!

9) Screen Time Reduction: Following overwhelming amounts of evidence and research, coaches may recommend eliminating or reducing video games, smart phone, iPad, YouTube, etc. for better outcomes. This is a reccomendation, not a mandate. The benefits of significantly decreasing or eliminating screens are profound. Yes, we know this is not easy, however, the families that are able to do this typically always see much more success 

10) No Services with Unpaid Invoices - Services are always placed on hold is any invoices are left unpaid. 

Important Reminders:
- No contracts or long-term commitments - Cancel anytime.
- If dissatisfied, cancel immediately - No refunds or guarantees.
- Children need privacy during virtual sessions. Parents will learn everything during coach communication.
- Coaches can be reassigned if needed. We do our best to assign "Best-Fit". 

-GrowNOW often has a multi-week or month waiting list. The Coach-Parent relationship is absolutely crucial for success, so we do not rush connecting families with the first available coach. 

Next Steps

1) Submit forms to be added to the waiting list. You'll be matched with the best-fit coach based on what you wrote on the Intake Form.

2) A free introductory conversation with the coach takes place before the first paid session to build a strong positive and trusting relationship. You will then schedule sessions directly with your assigned Best Fit Coach. 

Sign Here if all information above is fully agreed upon by all parties:

**Signature below is legal confirmation that you have read and reviewed the entire GrowNOW Policies and are in full agreement with all details: