Caregiver Coaching Agreement

Complete this form prior to your first coaching session.

Agreement

  • We are engaging in a coaching relationship

    You (“Client”) are voluntarily enrolling in this process.

    Caregiver Coaching is focused on providing education, support, tools and mentoring to caregivers/care partners with the goal of increasing confidence to successfully navigate the caregiving challenges ahead. In coaching, the coach facilitates your learning and supports your exploration. Your decisions to act are your own, and you do not hold the coach or Compassion Works, LLC responsible or liable for your experience or the actions you choose to take.

    This is a fee for service arrangement

    Client agrees to pay for phone coaching and/or in person coaching. The frequency and duration of phone calls or in-person coaching sessions may vary depending on your preference and our calendars.

    Payment

    Payment is due on the date of, or in advance of the coaching sessions. Payment can be made when scheduling on www.kaymadams.com or by mailing a check to:

    Compassion Works, LLC
    3291 Garland
    Wheat Ridge, CO 80033

    Cancellation

    Client agrees to notify Coach 24-hours in advance of any scheduled session of any scheduled session that he/she needs to cancel. This notice is appreciated and required. Coach reserves the right to charge Client for the session if session is not cancelled. If you have an appointment on a Monday, request for cancellation or reschedule must be made the prior Friday by the appointment time scheduled for Monday.

    Coach-Client Relationship – Duties and Responsibilities

    This relationship is a partnership between two or more individuals. Each party must uphold their obligations for the coaching relationship to be successful. Client and Coach agree to communicate honestly, be open to feedback and suggestions, and to fully engage and devote himself/herself to the coaching process.

    Coaching Sessions

    For phone or Zoom appointments, you can reach me at 303-875-5508.

    ALL CALLS ARE SCHEDULED IN MOUNTAIN TIME.

    Thank you for the opportunity to support you on this caregiving journey!

 

Signature

 

Verification

If you prefer, print this form and mail to Compassion Works instead of submitting online. It’s also handy to keep a copy of this form for your records.

Caregiver Coaching Agreement (Printable PDF version)

Don’t forget to complete your New Client Questionnaire

New clients have two forms to fill out. If you haven’t completed your questionnaire, you can complete it now.

New Client Questionnaire

Compassion Works, LLC enthusiastically engages care partners and organizations impacted by dementia through coaching, consulting, education and training, so they are empowered to effectively face challenges with confidence, clarity and connection.

We’d love to hear from you!

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