BALANCE Life Strategies Coaching - Agreement Form
BALANCE Life Strategies Coaching - Reach Goals, Find Balance and Repower your life!
Life Coaching Agreement

Susan Jones, CLSC, CSC, 
(Certified Life Strategies Coach, Certified Stress Management Coach)
sjones@balancelifestrategies.com


Welcome to Balance Life Strategies Coaching.  Prior to entering into a Life Coaching relationship, please read the following agreement carefully and indicate your understanding by submitting the form. I ask that you also submit the intake questionnaire form. If you have questions, please consult me before signing.The services to be provided by Susan Jones, Certified Life Coach, are coaching as designed jointly with the client. The fees for coaching are listed on the Book Now/Rates page of the website and must be paid in advance prior to each session. I ask that you give 24 hours notice if you need to cancel or change the time of appointment. Our easy to use online booking system allows you to book and cancel appointments quickly and conveniently.  


  1. I understand that life Coaching is based on a relationship with a Life Coach who co-facilitates with me to establish long-range goals and the achievement of those goals along with short-term objectives.
  2. I understand that the role of the Life Coach is to assist me with improving the quality of my life. I understand that my coach will be honest and straightforward, and will use challenging techniques to move me forward. If coaching is not working as you wish, you should let me know immediately so that we can take steps to correct the problem. If either of us recognizes that you have an issue that would benefit from psychotherapeutic intervention, I will refer you to appropriate resources.
  3. I understand that Life Coaching is comprehensive in that it deals with almost all areas of my life including work, health, relationships and spiritual issues. I acknowledge that deciding how to handle these issues and implementing my decisions remain my exclusive responsibility.
  4. I understand that Life Coaching is for people who are already basically happy, well adjusted and emotionally healthy.
  5. The Coaching relationship is a professional relationship and NOT one that can extend beyond professional boundaries.
  6. I understand that the Life Coach is legally and ethically bound to protect the confidentiality of our communications. However, confidentiality will not apply when it is necessary to protect you or others from harm.  If, as your coach, I have information that indicates that a child or elderly or disabled person is being abused, I must report that to legal authorities. If a client is an imminent risk to him/herself or makes threats of imminent violence against another, I am required to take protective action. Although these situations are rare in coaching situations, if it does occur, I will make every effort to discuss it with you before taking action. As you are aware, it is impossible to totally protect confidentiality of information that is transmitted electronically. This is particularly true of e-mail and the internet.
  7. I understand that Life Coaching DOES NOT treat mental illnesses that are defined in the “Diagnostic and Statistical Manual of Psychiatric Disorders” (DSM).  If I have anything in my past history indicating that I have an unresolved emotional or physical problem or a mental illness, I certify that I am not using Life Coaching as a substitute for assistance from a trained mental health professional or a medical doctor.
  8. I WILL NOT use Life Coaching as a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment.
  9. If I am currently in therapy or under the care of a mental health professional. I will have consulted with that person regarding the advisability of my working with a Life Coach. Additionally, I will inform my Life Coach of this relationship.
  10. I WILL NOT use Life Coaching in lieu of professional medical advice, legal counsel, accounting assistance, business consultation, or spiritual advice, and for each of these areas I understand that I should consult the appropriate professionals. I acknowledge that I will not use Life Coaching as a substitute for such professional guidance and further acknowledge that decisions on dealing with these issues lie exclusively with me.
  11. I agree to complete regular evaluations of the Life Coaching process and notify my coach immediately of any concerns.
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By submitting this form, I agree to the above terms and service of this Life Coaching Agreement.
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