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Have you had any previous therapy/coaching?
Do you have any diagnosed mental health or medical conditions?

If yes, please give details:

Are you currently taking any medication?

If yes, please list:

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Dialogue Destiny Coaching & Hypnotherapy Agreement.

This document outlines the terms and conditions between you (the Client) and Dialogue Destiny (the Certified Life Coach) regarding the therapy and coaching services provided.



1. Free Initial Consultation

  • A free 20-minute consultation call is available to all prospective clients.

  • This call provides an opportunity to discuss your needs and goals and determine whether the therapy and coaching sessions are suitable for you.

  • There is no obligation to continue after the consultation call if you feel the service is not the right fit.

2. Therapy and Coaching Sessions

  • Each therapy/coaching session, including the first full session, will last for 50 minutes.

  • The first session will be used to clarify your reasons for seeking therapy and coaching and to gather relevant personal history and details.

3. Fees

  • The fee for a one-to-one therapy/coaching session is £75 per session.

  • A bundle of 5 one-to-one therapy/coaching sessions is available at a discounted rate of £300.

  • Relationship Therapy and Coaching Package (5 sessions):

    • Includes 3 couples sessions and 1 individual session for each partner.

    • The total fee for this package is £480.

  • Payment for the first session is required in advance. Thereafter, each session must be paid for in full at the end of each appointment unless purchased as a prepaid bundle.

  • Clients purchasing a bundle or a relationship package must pay the full package fee upfront before sessions commence.

  • Advance payment may also be made by paying two session fees at the first appointment, or by dividing the advance fee over the first two sessions (this will be held as payment for your final session).

4. Attendance and Punctuality

  • Please arrive punctually for your therapy/coaching session. If you are late, the session will still end at the scheduled time and cannot be extended.

  • If you are unable to attend your appointment, you must provide at least 24 hours' notice.

  • If less than 24 hours' notice is given, or if the appointment is missed without notification, the full session fee will be charged.

  • Clients are encouraged to give 48 hours' notice where possible when cancelling or changing an appointment.

  • For prepaid bundles and packages, missed or cancelled sessions with less than 24 hours' notice will still be counted towards the total sessions booked.

5. Communication Outside Sessions

  • Communication with your certified life coach outside of therapy/coaching sessions is limited to arranging, cancelling, or rescheduling appointments, unless a prior agreement is made.

6. Confidentiality

  • Therapy and coaching sessions are confidential.

  • Brief notes may be kept during therapy/coaching for professional purposes. These will be securely stored separately from your personal details.

  • Your certified life coach attends regular supervision sessions to maintain professional and ethical standards.

  • Exceptions to confidentiality apply if:

    • The certified life coach believes you are at serious risk of harming yourself or others.

    • You disclose involvement in terrorism, drug trafficking, or money laundering; in these cases, the coach is legally required to inform the appropriate authorities.

    • The coach has serious concerns requiring contact with your GP (General Practitioner), which you agree to as a condition of accessing therapy/coaching services.

7. Client Responsibilities

As a client, you agree to:

  • Attend therapy/coaching sessions punctually.

  • Be drug-free and alcohol-free when attending all therapy/coaching sessions.

  • Provide a minimum of 48 hours' notice for cancellations or changes.

  • Pay the agreed session or package fee in advance, or in full at each appointment.

  • Communicate outside sessions only for appointment management, unless otherwise agreed.

  • Show respect to the certified life coach and their property.

  • Give permission for the certified life coach to contact your GP if there are serious concerns about risk to yourself or others.

  • Discuss with the coach when you feel ready to complete your therapy/coaching journey.

  • Inform the certified life coach if you are currently in or considering entering another coaching or therapeutic relationship.

8. Certified Life Coach Responsibilities

As your Certified Life Coach, I agree to:

  • Be available at the agreed time.

  • Start and end sessions punctually.

  • Offer a quiet, appropriate, and undisturbed space for therapy/coaching.

  • Maintain safe and professional boundaries at all times.

  • Regard all client contact and information as confidential unless I have reasonable doubt concerning the actual safety of the client or others.

  • Encourage and support client autonomy throughout the therapeutic process.

  • Review therapeutic work and the client-coach relationship regularly.

  • In the unlikely event that I must cancel a session, offer an alternative appointment as soon as possible.



Agreement

By signing below, you acknowledge that you have read, understood, and agreed to the terms outlined above.

Client Name: ______________________________ Signed


Client: ____________________________ Date: _____________


Certified Life Coach Name: __________________________ Signed Certified


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