Client Agreement Form

This agreement is entered into by the individual listed above (“Client”) and Monica Humpal (“Coach”), and pertains to Marriage Coaching which shall occur via telephone or Zoom, as negotiated between Client and Coach.

I hereby employ Monica Humpal as my "Coach" for the purpose of advising and coaching me with respect to the proper format for Marriage Coaching.  She may also assist me in structuring, identifying and achieving goals as she has experience in such matters and agrees to render such services.

I understand and agree that the Coach is not an "employment agent," "business manager," "financial analyst" or "psychotherapist" and that she has not promised, shall not be obligated to, and will not: (1) procure or attempt to procure any employment, business or sales for me, (2) perform any business management functions such as accounting services, advice on tax matters or the investment of funds, and (3) will not act as a therapist, counseling me or providing psychoanalysis, group therapy or behavioral therapy. 

I further understand and agree that as a specialized form of consulting, Coaching is not the same as professional or licensed therapy; and that I am always free to reject any advice, suggestions or requests made by the coach at any time. My coach is authorized and encouraged to be direct and unconditionally supportive with me

I further understand and agree that I am to inform my Coach whenever I am under the care of any healer or licensed physician, therapist or psychiatrist; and/or any time I am taking any prescriptions or drugs.

This agreement will remain in effect when the Coach and Client are in an active coaching relationship and actively meeting for coaching sessions.

Client understands and agrees to retain the Coach and meet via Telephone or Zoom at the rate as agreed based upon the coaching package selected by the Client. If the meeting is to take place via telephone, the Coach will call the Client at the agreed upon meeting time. Client is to make the calls with the coach a priority and answer promptly. If meeting via Zoom, the Coach will share the Zoom link with the Client via email. Coaching sessions will last approximately 60 minutes.

Client understands and agrees to make coaching sessions a priority, and to arrive on time for scheduled appointments. Client further understands and agrees that if they have not rescheduled a call 24 hours in advance, or does not call the coach within 15 minutes of a scheduled coaching time, the coach will assume the client has elected not to avail themselves of that particular coaching session. As there are no refunds, any misses sessions will not be refunded and will not be carried over to a future coaching package. However, the Coach reserves the right to make exceptions in situations where the Client had unforeseen circumstances that prohibited them from attending their scheduled session.

All payments are due before the first session can be scheduled. There are no refunds.

AS A CLIENT, I UNDERSTAND AND AGREE THAT I AM FULLY RESPONSIBLE FOR MY WELL BEING DURING MY COACHING CALLS, 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 AND THAT PROFESSIONAL REFERRALS WILL BE GIVEN IF NEEDED. I ALSO ACCEPT THAT IF MY COACH SUSPECTS THAT I OR SOMEONE I KNOW COULD BE IN A HARMFUL SITUATION MY COACH CAN CONTACT THE POLICE AND THE CLIENT CONFIDENTIALITY CLAUSE WILL BE NULL AND VOID.

By clicking the "Submit" button below the above named "Client" is in agreement with this document and all held herein.