To be filled out and signed only if we agree to work together.
Scope of Service
This document is a coaching agreement between you (“Client”) and me, David S. Klajic (“Coach”). In addition to being a coach, I am a licensed psychologist in the state of Alabama. Coaching and psychotherapy are different services that serve different purposes.
Psychotherapy is a regulated healthcare service for diagnosing and treating cognitive and emotional difficulties. The goal of psychotherapy is to alleviate symptoms and prevent relapse. Coaching, in contrast, is an unregulated service for helping clients identify and work toward personal and professional goals. Coaching is not therapy or mental health care. I offer coaching to adults over the age of 18 in the U.S. and Canada.
The relationship between Coach and Client is specifically designed to avoid the power differentials that can occur in a clinical psychotherapy relationship. Coaching also involves a much lower degree of professional responsibility for client safety. The coaching relationship is designed to be direct and challenging in order to help you move toward your goals.
The separate roles of Coach and psychotherapist potentially conflict with each other. Under most circumstances, it is unethical for a Coach/clinician to play both roles with a client, whether concurrently or sequentially.
This means that if either of us recognize that you are experiencing a problem that would benefit from psychotherapy, I will attempt to refer you to more fitting resources. Coaching is not a substitute for professional advice by legal, medical, or other qualified professionals, nor is it a substitute for mental health treatment.
I also ask you to inform me of any psychological or psychiatric treatment you undergo during the course of our work so that I will not inadvertently interfere with that treatment. In most cases, coaching should wait until treatment is complete.
It is also important to understand that coaching is a professional relationship. While it may often feel like a close personal relationship, it is not one that can extend beyond professional boundaries either during and after our work together. Considerable research shows that blurred boundaries undermine the hard-won benefits gained from this type of working relationship.
I cannot and do not assume responsibility for any choices you make, or actions you take, resulting from our work. I make no guarantees or warranties, and by signing this agreement you guarantee that in no event will you hold me responsible for consequential or special damages.
Change often makes the people around us uncomfortable or even angry. You may experience resistance, unpleasant interactions, or even retribution from those around you if you make decisions they dislike. You alone are responsible for the outcomes of your actions and inactions. The good news is that you are also fully responsible for the benefits resulting from your decisions.
I am ethically bound to protect the confidentiality of our communications, and I take that responsibility seriously. I will only release information about our work to others with your written permission, or in response to a court order, or due to the special circumstances listed below.
I am legally obligated to break confidentiality in order to protect you or others from harm. If I have information indicating that a child or elderly or disabled person is being abused, I must report that to the appropriate state agency.
I am required to take protective actions if a client is an imminent risk to him or herself, or if he or she makes threats of violence against another. I am also forced to break confidentiality in the event I must initiate collections proceedings.
As I’m sure you’re aware, it is impossible to fully protect the confidentiality of information that is transmitted or stored electronically. While I take precautions, I do not assume responsibility for the actions of third parties who choose to violate our privacy by intercepting or stealing information. By signing this agreement, you are agreeing to conduct business with me electronically, and you release me from any liability or responsibility for the behavior of third parties who may gain access to your information.
Frequency of Meetings
Most clients choose to meet weekly or every other week. Some people find it useful to meet more or less often, and I usually ask clients to do homework between meetings. I may make recommendations about the frequency of our meetings, but ultimately you determine how often we meet. I won’t badger you to set up the next appointment.
Fee and Payment
The service to be provided by me, David S. Klajic, PhD., is coaching by video, telephone, or in person, as designed jointly with you, the Client. The fee for services is $125 per hour. Unfortunately, experience has taught me to ask for payment in advance of our meetings.
Professional time spent outside of coaching sessions, including but not limited to between-session phone calls or email exchanges, may be billed on a prorated basis rounded up to the nearest tenth of an hour.
I use electronic invoicing delivered to your email address unless we make other arrangements. Please be aware that this means receipts for my services may appear in your email inbox, and a listing of my services may appear on your credit card statement.
I ask that you please give 24 hours notice if you need to cancel or change the time of appointment, otherwise I must charge for the missed appointment. Please note that accounts more than 30 days overdue may be referred to a collection agency.
Coaching is designed jointly and may be terminated by either the Coach or the Client at any time, without penalty. In fact, I ask you to continually monitor the usefulness of our work. I don’t wish to waste your time and money. Likewise, I reserve the right to terminate our work or to refer you to more appropriate services at any time.
If a dispute arises out of this agreement that cannot be resolved by mutual consent, the Client and David S. Klajic agree to mediate in good faith for up to 90 days after notice given.
This document reflects the entire agreement between David S. Klajic and the Client, and reflects a complete understanding of the parties with respect to the subject matter. This Agreement supersedes all prior written and oral representations.
I prefer to use the Doxy platform, as it is more secure than Skype. If we work together, I will send you the link. There is nothing for you to download.