DISCLOSURE & INFORMED CONSENT

OVERVIEW

The coaching relationship is both a personal and contractual agreement. To ensure clarity, this document outlines the expectations and framework of our work together. If you have any questions, please discuss them with your coach. By signing this document, you acknowledge that you have reviewed and agreed to its terms.

THE COACHING PROCESS

Choosing coaching is a proactive step in personal growth. The success of coaching largely depends on your engagement and willingness to embrace potential discomfort in pursuit of your goals. Coaching is not a substitute for therapy; it is a forward-focused process. Copper Warrior Coaching cannot guarantee behavioral or circumstantial changes but is committed to providing guidance, understanding, and support to help you clarify and pursue your objectives.

CONFIDENTIALITY

Your participation in coaching and the content of sessions are protected by legal confidentiality.

However, exceptions include:

• If you provide written consent to release information.

• In the event of your death or disability, disclosure to a personal representative.

• If you waive confidentiality by initiating legal action against your coach.

• Compliance with valid subpoenas or regulatory investigations.

• If there is an imminent risk to your safety or the safety of others.

• If payment is not received after 90 days, minimal information may be disclosed to a collection agency.

• Mandatory reporting of suspected child or elder abuse, or imminent harm.

• Consultation with colleagues to provide the best coaching experience, disclosing only necessary information.

• In case of a coach’s incapacitation, a designated professional may access your file to ensure continuity of care.

Given our work with first responders, you may encounter your coach in public. To protect confidentiality, your coach will not acknowledge you first. If you choose to initiate contact, the interaction will remain brief and professional.

PRACTICE POLICIES

APPOINTMENTS AND CANCELLATIONS

All sessions must be paid for at the time of booking in order to secure an appointment. In the event that a client must cancel their session, the balance will be transferred to the client’s next session unless the session is canceled with less than 24 hours' notice.

FEES & BILLING

Individual coaching sessions (60 minutes): $150Payment is required at the time of booking to secure an appointment.A credit card is required on file for auto-pay and outstanding balances.Fee increases may occur annually with 60 days' notice.

INSURANCE

Coaching is a self-pay service and is not covered by insurance.

LEGAL PROCEEDINGS

Erin Maccabee dba Flashpoint Coaching provides coaching for personal growth, not for legal proceedings

.If involvement in legal matters is requested, the following fees apply:

Preparation & document submission: $200/hr

Phone calls: $300/hr

Depositions: $350/hr

Court testimony: $350/hr

Time away from office: $300/hr

Mileage: $0.80/mile

Court document filing: $200Legal fees incurred by the coach

TERMINATION

You may discontinue coaching at any time. If termination is initiated by the coach, we will discuss the reasons and provide referral options. If you cancel or fail to schedule sessions for three consecutive weeks without prior arrangements/communication, we will assume you have chosen to terminate services.

ACCESS TO CLIENT RECORDS

Clients have the right to access their records and disclosure history. Copying or compilation fees may apply. Requests for progress reports or care coordination beyond 15 minutes will be billed at a prorated session rate.

TELEPHONE ACCESSIBILITY

For non-emergency matters, leave a message, and your coach will respond within

24 hours

In emergencies, call 911 or the national crisis line at (800) 273-8255

.

SOCIAL MEDIA & ELECTRONIC COMMUNICATION

To protect confidentiality, we do not accept personal social media connections from clients. Electronic communication, including text and email, is not fully secure. While these methods may be used for scheduling, please avoid discussing coaching content electronically. Response times may vary.

AUTHORIZATION FOR PAYMENT INFORMATION

I authorize Flashpoint Coaching to keep my signature and card information on a virtual terminal file that is password-protected. This authorization allows for the charging of coaching session fees (individual, group, workshops, couples, family, or other.)

These fees will be charged to my credit, charge, or debit card as listed below for services provided.

I understand that this authorization is valid until canceled in writing. While this information is secured in an online protected client file, I acknowledge and assume the risk in the unlikely event of a security breach. Charges for ongoing services will be charged upon session booking.

I agree that if I have concerns regarding charges, my card becomes inactive, or a charge fails, I will contact the office. I will not dispute charges with my credit card company unless I have attempted resolution with Copper Warrior and those attempts have failed.

ACKNOWLEDGMENT & CONSENT

By acknowledging this document, you affirm that you:

Have received, read, and understood this agreement.

Acknowledge your rights and privacy under HIPAA.Consent to participate in coaching services under these terms.