Informed Consent & Coaching Agreement
Grace Shannon Wellness, LLC · Marchelle Brinson, Founder · contact@graceshannon.net
This Informed Consent & Coaching Agreement ("Agreement") governs the professional relationship between Grace Shannon Wellness (the "Coach") and you (the "Client"). By booking a session, completing the intake process, or participating in coaching services, you acknowledge that you have read, understood, and agreed to the terms below.
Please read this Agreement in its entirety before your first session. If you have questions about any section, please contact us at contact@graceshannon.net before proceeding.
1. Nature of the Coaching Relationship
Grace Shannon Wellness provides non-clinical Relational Wellness Coaching designed to support personal growth, relational wellness, communication, family dynamics, emotional awareness, practical skill development, and navigating life transitions.
Coaching is a collaborative, forward-looking process. The coach and client work together to identify goals, explore perspectives and patterns, develop practical strategies, and identify intentional steps that support the client's desired growth and development.
Coaching is not psychotherapy, clinical counseling, psychological assessment, medical care, or treatment for mental health or medical conditions. The coach does not diagnose or treat mental health conditions, provide psychological testing, or prescribe or manage medications.
The coaching relationship is based on the understanding that the client is responsible for their own choices, decisions, actions, and outcomes. The coach provides guidance, questions, education, encouragement, and practical tools; however, the coach does not make decisions on behalf of the client or guarantee specific outcomes.
If information shared during the coaching process suggests that a client's needs may be better addressed through clinical, medical, or other licensed professional services, Grace Shannon Wellness may recommend that the client seek appropriate professional support. Coaching may be paused, modified, or concluded when circumstances indicate that services outside the scope of non-clinical coaching are more appropriate.
By participating in coaching, the client acknowledges and agrees to the nature, purpose, and professional boundaries of the coaching relationship described above.
2. Scope of Services
I have read and understand the Grace Shannon Wellness Scope of Practice. I understand that Grace Shannon Wellness provides non-clinical Relational Wellness Coaching and related wellness coaching services focused on personal growth, relationships, family dynamics, children and youth, communication, emotional awareness, practical relational tools, personal accountability, and navigating life transitions.
I understand that coaching services are not clinical in nature and do not include psychotherapy, clinical counseling, psychological assessment, diagnosis, treatment of mental health conditions, medical treatment, medication management or guidance, or other services outside the scope of non-clinical coaching.
The Coach does not diagnose or treat mental health or medical conditions and will not represent coaching services as a substitute for appropriately licensed healthcare or mental health services.
Coaching Services for Minors
Coaching services provided to children and youth require the knowledge and consent of a parent or legal guardian, consistent with applicable requirements and the specific coaching arrangement.
Coaching for minors remains strictly non-clinical and is focused on age-appropriate personal growth, communication, emotional awareness, relational skills, practical coping and self-management strategies, decision-making, and personal accountability.
Whether services are provided to an adult, child, or youth, the coaching relationship remains within the established non-clinical scope of Grace Shannon Wellness.
I understand the scope and limitations of the services provided by Grace Shannon Wellness and acknowledge that coaching is not a replacement for medical, psychological, psychiatric, or other licensed professional services when those services are needed.
3. Confidentiality & Its Limits
Grace Shannon Wellness maintains confidentiality to the fullest extent permitted within a non-clinical coaching relationship. Information shared during coaching sessions, whether with adults, couples, families, or minors, will be kept private except in situations where disclosure is legally or ethically required.
Confidentiality may be broken if any of the following occur:
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Imminent risk of harm to yourself or others
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Disclosure or reasonable suspicion of child abuse or neglect
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Disclosure or reasonable suspicion of elder abuse or abuse of a vulnerable adult
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Threats of violence, self-harm, or harm to others
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A court order or legal requirement compelling disclosure
For minors: Parents or legal guardians may receive general updates about progress, safety concerns, or issues requiring parental involvement. Specific details shared by a minor may remain private unless safety concerns arise or disclosure is necessary for the child's well-being.
In couples or family coaching, information shared individually may be discussed in joint sessions unless otherwise agreed to in writing. Coaching communications are not protected by therapist-client or patient-provider privilege.
4. Session Recording Policy
I understand and consent that Grace Shannon Wellness records coaching sessions, including audio and video, for the purposes of accurate note-taking, quality improvement, and internal professional development. Recordings are stored securely and are never shared with outside parties unless required by law or with my explicit written consent.
For minors: Session recording requires the knowledge and consent of a parent or legal guardian. By booking and participating in services for a minor, the parent or legal guardian acknowledges and agrees to this recording policy.
5. Referral
I understand that if my Coach identifies needs that exceed the scope of non-clinical coaching, including indicators of clinical mental health conditions, trauma responses, domestic violence, substance abuse, self-harm, or suicidal ideation, they will refer me to an appropriate licensed mental health professional. The Coach reserves the right to pause or discontinue coaching services if clinical concerns arise. I agree to consider such referrals in good faith.
For minors: If clinical concerns are identified, the Coach will notify the parent or legal guardian and provide appropriate referral recommendations.
6. Right to Terminate
Either party may terminate the coaching relationship at any time for any reason with written notice.
For minors: Termination may be initiated by the parent or legal guardian.
7. Financial Agreement
I agree to the fees associated with my selected service or package. Payment is due at the time of booking unless a payment plan has been established and approved by Grace Shannon Wellness in advance.
For minors: The parent or legal guardian is responsible for all associated fees.
8. Cancellation & Refund Policy
I understand that at least 48 hours' advance notice is required to cancel or reschedule any session. Sessions canceled with less than 48 hours' notice will be charged in full. No-shows will be charged in full. No refunds will be issued for completed sessions.
9. Communication Boundaries
I understand that between-session communication is intended for brief check-ins only and is not a substitute for scheduled coaching sessions.
For minors: Communication between sessions is conducted with the parent or legal guardian unless otherwise agreed in writing.
10. No Guarantee of Results
I understand that coaching outcomes vary based on each client's level of engagement, participation, honesty, effort, follow-through, and individual circumstances. No specific results or outcomes are guaranteed.
I enter into this coaching relationship with realistic expectations and understand that meaningful progress depends significantly on my participation, effort, and implementation of strategies discussed during coaching.
For Minors: Progress may also be influenced by the consistency of support provided outside of coaching sessions. Parents or legal guardians enter into this coaching relationship with realistic expectations and understand that a minor's progress depends significantly on the minor's participation and follow-through, as well as appropriate support and reinforcement from parents or legal guardians outside of sessions.