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  • Health Coaching Client Agreement Form

    PowerPlant Fitness & Nutrition
  • Thank you for joining PowerPlant Nutrition on your journey towards a better relationship with food and body! I am so happy you have chosen to work with me as your Health Coach. I am committed to helping you reach your highest goals and want you to have the best possible experience during our coaching sessions together.

    In this agreement I have included information regarding our future work together. I ask that you read, sign and date this form to show that you agree to abide with the guidelines outlined within it. Should you have any questions or need more clarification, please do not hesitate to contact me.

    The Nature of Coach/Client Partnership:

    Health Coaching (further referred to as Coaching in this document) is a respectful mixture of inquiry, conversation, listening, teaching points, experimentation, exploration and well chosen action steps. It's designed to help you reach your highest goals, to properly evaulate and re-adjust your goals as necessary, and help you have an empowered relationship around food and body.

    The Role of the Coach:

    The role of the coach is to assist with the improvement of eating challenges such as unhealthy eating, overeating, binge eating, body image, chronic dieting, and nutrition related health concerns such as digestion, fatigue, mood, and more. Coaching services are not to be construed as, or a replacement for psychotherapy, legal advice, or medical advice. If either of us recognizes that you have an issue that would benefit from medical or psychotherapeutic intervention, I will do my best to refer you to the appropriate resources.

    The Responsibility of the Client:

    Ultimately, the coaching relationship is about you, the client, taking full responsibility for your actions, and your life. You enter into coaching with the understanding that you are responsible for creating your own decisions and results. You agree not to hold the coach liable for any outcomes resulting directly or indirectly from the coaching process.

    Honesty:

    I will do my very best to be honest and straightforward during our work together. If there is anything that is not satisfactory for you about our work together, please let me know immediately so that we can take steps to make the appropriate corrections. I encourage you to honestly tell me what is going on on your end. If I ever say or do something that upsets you or doesn't feel right for you, please bring it up during our time together. Honesty and trust are critical for our success in this work together. I want our time together to be an open and safe place in which you can come with confidence and excitement. 

    Cancellations and Re-scheduling:

    I understand that there are times when you will need to cancel and/or re-schedule your appointment, and I will do my best to accomodate your needs if at least 24 hours notice is given. I request that you honor this policy as diligently as possible. If you cannot comply, any session cancelled within the 24 hour period is a 'late cancel' and will be appropriately charged. Please call or text me at 817-262-0428 if an appointment needs to be cancelled or rescheduled. 

    Refunds:

    As your coach I want you to succeed in meeting your goals. I will do everything within my coaching duties to provide you with what you need to get there. There are, however, some times where the desired goal is not achieved. I cannot be help responsible for results or lack thereof, and no refund may be given for health coaching services once services are rendered. 

    Confidentiality:

    Confidentiality is important to me. I will keep all information exchanged between us confidential. I will not disclose any information that you share with me with anyone else unless: 1) I believe you are at risk of being a danger to yourself or others, 2) when required by law, or 3) you have given me prior written permission. All written records of our exchanges kept on my laptop or cell phone will be password protected. The one exception to this confidentiality rule is that any form of positive testimonial you share with me can be shared via social media and other online resources after the removal of your visible personal information.

    Preparation:

    To ensure the most productive use of our coaching time together, please come to each session/call with some preparation. Take some time to consider the progress you have made and how you would like to use the upcoming session/call. Use any of the following questions or invent your own. You can email your responses to any or all of the following questions to me ahead of time at nickie.harris16@gmail.com.

    1. What progress have I made since our last session?
    2. How well did I stick to my goals set in the last session?
    3. What challenges did I face?
    4. How did I handle them?
    5. What new insights have emerged?
    6. How would I like to focus this next session?

    Coach Availability:

    If you have a short question or request for feedback in between our sessions, the easiest way to get in touch with me is via the PT Distinction App. If we are not using that for your program, please use text messages. I will do my best to answer all your health and fitness related texts within 12 hours. I will also be available to you during our agreed upon meeting times. Part of my role as your Coach is to check in with your progress periodically, so you can expect contact from me regarding your established goals and action steps. Please do your best to respond to my contact within 12 hours so that we can keep progressing towards your goals. 

    Payment Policy:

    Your payment may be made by Venmo, CashApp, or PayPal (friends and family payment option only. Client will be responsible for Paypal fees if the friends and family payment option is not used). My Venmo username is @Nickie-Harris. All sessions/programs must be paid for within 24 hours before that session/program begins. An invoice for payment can be requested and must be paid by the due date. Non-payment for services will result in a cancellation of services, retrieval of any electronic services rendered, and pursuit of payment to the furthest extent of the law. 

    Insurance:

    Unlike traditional medical care, Coaching is not covered by health insurance. At this time I cannot accept insurance for Coaching services.

    Referrals:

    If you are benefiting from our relationship, I would love if you would suggest my services to appropriate friends, family and colleagues. Any successful referralys will result in a $50 credit to your account, or me just sending you $50. Additionally, if you would be willing to offer your testimonials to be used on my website, that would be of tremendous help. You can submit your testimonial at thmtk.com/FgMT85QD. 

    When You Are Ready to Fly Solo:

    My role as your coach is to guide you towards the solutions and strength that already exist within you. Naturally, there will come a time where you have developed all the skills you need for the time being and you no longer need one-on-one coaching. When that time comes, I ask that you please let me know. This is actually a success for me, so don't feel bashful! When you feel confident to go it alone, that means I have done my job. But don't forget that I will always be here should you need me, whether it be for a new goal or an old habit.

    Your signature on this document is acknowledgement that you have received, read and agree with this notice of our Client Agreement.

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