Coaching Client Packet

Welcome. Please complete each section below and sign at the bottom. Your responses go directly and privately to Amy so we can begin with a shared foundation before our first session.

Client Information

Full legal name

Preferred name

Date of birth

Phone

Mailing address

Emergency contact name

Emergency contact phone

Relationship to you

I give Whole Again permission to contact the emergency contact above only when reasonably necessary for an urgent safety concern.

Coaching Intake

What brings you to coaching at this time?

What would you most like to understand, change, or strengthen?

What would make coaching feel meaningful or successful for you?

What support systems or resources are currently available to you?

Is there anything you would like me to know so I can support you more effectively?

Current Goals & Priorities

My three most important goals right now

One small change I would like to notice first

Coaching Agreement

Purpose of Coaching. Coaching is a collaborative, educational, and goal-oriented process intended to support personal growth, clarity, self-awareness, decision-making, and action.

Scope of Practice. Whole Again coaching is not psychotherapy, counseling, medical care, legal advice, crisis intervention, diagnosis, or treatment of a mental health condition. Amy Carmen is serving in the role of coach, not therapist or healthcare provider. You are encouraged to seek appropriately licensed professionals whenever your needs fall outside the scope of coaching.

Client Responsibility. You are responsible for your own decisions, choices, actions, wellbeing, and results. Coaching outcomes cannot be guaranteed.

Sessions. Session length, frequency, format, and fees will be agreed upon before services begin. Please arrive on time and prepared to participate.

Communication. Routine communication between sessions should be used for scheduling or brief coaching-related matters. Coaching by email or text is not intended for emergencies.

Scheduling & Cancellation. Please provide at least 24 hours’ notice when rescheduling or canceling a session. Late cancellations and missed appointments may be charged, except where Whole Again agrees that circumstances warrant an exception.

Fees & Payment. Current coaching fees and package terms will be provided before purchase. Payment is due according to the selected service or package terms.

Refunds. Any refund or package policy provided at the time of purchase will govern. Used sessions are not refundable.

Confidentiality. Whole Again will treat coaching communications as private and will take reasonable steps to protect your information. Coaching confidentiality is not the same as therapist-client privilege and may be limited when disclosure is required by law or reasonably necessary to address an imminent safety concern.

Technology & Virtual Sessions. For virtual coaching, you are responsible for choosing a reasonably private location and maintaining suitable internet access. Electronic communication and video platforms carry inherent privacy risks.

Safety & Crisis Policy. Whole Again coaching is not an emergency or crisis service. If you are in immediate danger or experiencing an urgent medical or mental health crisis, use appropriate emergency or crisis services in your area rather than waiting for a coaching response. If concerns arise that are beyond the scope of coaching, Whole Again may pause or end coaching and recommend that you seek support from a licensed professional.

Acknowledgments

Safety & Crisis — please check both to confirm

I understand that coaching is not a substitute for emergency, medical, psychiatric, psychological, or legal services.

I understand that I am responsible for seeking appropriate professional or emergency support when needed.

Consent & Acknowledgment — please check each to confirm

I have read and understand this Coaching Client Packet.

I understand the nature and limits of coaching.

I understand that Amy Carmen / Whole Again is not acting as my therapist, physician, attorney, or other licensed professional.

I understand the scheduling, payment, cancellation, privacy, and crisis policies described in this packet.

I understand that I am responsible for my own decisions and actions.

I have had the opportunity to ask questions before signing.

Signature

Typing your full name below is your electronic signature. By signing, you confirm that you have read, understand, and agree to this entire Coaching Client Packet — including all acknowledgments above — and that the information you have provided is accurate.

Client printed name

Client signature (type your full name)

Date