CONSENT & CONFIDENTIALITY AGREEMENT

I (client) consent to receiving therapeutic coaching sessions from Coach Natalie Syrmopoulos at Evolving With Natalie.

• I understand that the private information shared by the client during the group/individual coaching sessions is confidential. Evolving with Natalie will not voluntarily communicate the client’s information to a third party. In order to honour and protect the coaches’ intellectual property, the client likewise agrees not to disclose or communicate or sell information about the coach's practice, materials, or methods to any third parties.
• I understand I have the right to participate in or decline any or all proposed services.
• I understand that this service is not suitable for me if I struggle with suicidal thoughts or severe depression and I need to seek medical help for my condition. This service is suitable in conjunction with the medical help I receive for my depression.
• I understand this service is not a substitute for any medication I may be taking for my mental or physical health condition.
• I understand if I choose to stop any medication for my mental or physical health, that will be at my own risk.
• I understand this is not a medical program but a program I can use in conjunction to any medical/healthcare services I’m receiving at this time.
• I understand that to see results during my participation in the coaching I will need to commit to consistently and daily practicing the techniques discussed during the sessions. I understand that the results will vary depending on my commitment and dedication to practicing the techniques daily.
• I understand I will be responsible for completing my journal and my daily homework.
• I understand Evolving with Natalie reserves the right to terminate services with the client if the client acts inappropriately during the coaching session (inappropriate behaviours include bullying, harassment, hostility and inappropriate sexual behaviours) towards the coach or other members present during the session.

PARTICIPATION AGREEMENT FOR COACHING IN THE SELF CARE EMBODIMENT PROGRAM:

• I understand that the coaching sessions will teach me techniques that will transform my life.
• I understand that to see the results I will need to practice the techniques on a daily basis outside of the sessions.
• I understand I will be responsible for completing my journal and homework.

I have read the above authorization(s) and indicated my consent by checking the appropriate box. My consent is valid unless and until I withdraw it in the manner set out in this consent form.