Coaching Agreement

Thank you for choosing us! We are committed to providing quality care and service to all our patients. The following is our coaching agreement and financial policy, which we require that you read and agree to prior to any service.

The time of the coaching visits will be determined by Coach and Client based on a mutually agreed upon time. The Coach will initiate all scheduled calls via our telehealth app or telephonically.

Initially, you will have a 15-minute intro to coaching visit, followed by a 30-minute initial assessment visit and re-occurring weekly visits. If you need to reschedule any session, please let your coach know 24 hours in advance. It is asked for a commitment of at least three months. After that time, you and your coach will reevaluate your progress and, most likely, transition to bi-weekly for the following three months.

Preparation

After your initial session, you are asked to come to the coaching sessions prepared with an idea of what you’d like to achieve in each session as well as successes and challenges in the week leading up to your visit. It is also required you update your lifestyle data to review with your coach, and review any materials assigned at the previous visit.

Expectations

Coach’s Expectations:

• Coaches will be punctual, keeping scheduled appointments and ethically maintain confidentiality by obtaining consent to coach valued areas.
• Coaches will bring their full self to visits and listen with full presence providing a safe, supportive environment to increase trust and self-exploration of health, lifestyle, and wellness goal.
• Coaches will value the client as the authority for his or her own health and well-being by respecting client’s autonomy and support client's wisdom and natural intuition to determine next steps for best possible outcomes.
• Coaches will involve and guild you the client in creating SMART goals in your action plan.
• With permission, coaches will offer guidance, resources and relevant education for specific health concerns, conditions, nutrition and exercise.
• Coaches will recommend other healthcare professionals when they feel issues are outside of their scope of practice and experience.

Patient’s Expectations:

• As a client you are aware that the key to your wellbeing and success is YOU.
• You are ready to make a commitment for sustained change to improve health and wellness.
• You will commit to assessing your readiness for change and create an action plan towards your goals.
• You will make 30-day goals and a 6-month vision goal with the support of coaches and be prepared to discuss your progress during appointments.
• You will explore new ideas, behaviors, and actions that may involve risk-taking in fear of failure and or fear of success.
• You will take responsibility for learning new lifestyle behaviors.
• You will be open and honest so that the coach can access your deep wisdom self-awareness.
• You will integrate self-reflection and self-care practices each day.
• You will openly explore obstacles towards your goals.
• You will complete any required secure pre-visit health history form prior to visits.
• You will self-track lifestyle habits. You know that within InHealth, we connect with devices like scales, blood pressure cuffs, activity trackers and more.
• You will provide 24-hour notice for any appointments that need to be rescheduled and be punctual to all appointments.

By signing this agreement form, you are agreeing to abide by the expectations.

Termination

Because of the time, scope and nature of the work, the initial contract is for three (3) months of coaching. Thereafter, coaching is done on a month-to-month basis. If possible, it is asked that you let your coach know at least two weeks in advance if you would like to terminate your work together. You have the right to terminate or discontinue the coaching relationship at any time. After 3 consecutive No-Shows, we will consider our professional coaching relationship terminated.

Confidentiality

It is recognized that during the program, you may give your coach the following: future plans, health information, financial information, job information, goals, personal information, and other proprietary information. The coach will not at any time, either directly or indirectly, use any information for their own personal benefit, disclose, or communicate in any manner any information to any third party. The coach will not divulge that you are in a coaching relationship without your permission. The coach will hold everything that you say and do confidential unless you present a physical danger to yourself or others. In this case, the coach will inform legal authorities so that protective measures can be taken.

Nature of the relationship

You are aware that the coaching relationship is in no way to be construed as psychological counseling or psychotherapy. If you feel the need for professional counseling or therapy, it is your responsibility to seek a licensed professional. Coaching results are not guaranteed. You enter into coaching with the understanding that you are responsible for creating your own results.

You are solely responsible for creating and implementing your own physical, mental and emotional well-being, decisions, choices, actions and results arising out of or resulting from the coaching relationship and your coaching calls and interactions with the Coach. As such, you agree that neither your Coach nor InHealth is liable or responsible for any actions or inaction, or for any direct or indirect result of any services provided by the Coach. You understand that coaching is not therapy and does not substitute for therapy if needed, and does not prevent, cure, or treat any mental disorder or medical disease.

Remote Patient Monitoring (RPM)

Remote Patient Monitoring (RPM) is a part of our coaching program and allows coaches to assess important biometric data about you, including steps, weight, blood pressure, or heart rate, to provide additional tailored guidance based on that data.

You understand that:

• By consenting to this mobile application and accepting receipt of an RPM device/equipment, you understand that RPM is a part of the Coaching Program.
• Per provider approval, you will receive an RPM device and are required to use the provided equipment a minimum of 90 consecutive days. You agree that you are the only person to use the equipment as instructed. After the minimum 90 days is met, the device is yours to keep and you will not incur any costs for the device.
• If you already have an RPM device, such as an activity tracker, you are not required to use our equipment. You may, however, order and pay for additional devices through us.
• You will not use the device for reasons other than your own personal health monitoring. You understand that you can only participate in this program with one Medical Provider at a time.
• You are eligible for any applicable warranty through the device manufacturer.
• The devices used in the Health Coaching program are meant to collect information such as diet, exercise and activity, blood pressure readings, and/or blood glucose information. It is NOT AN EMERGENCY RESPONSE UNIT AND IS NOT MONITORED 24/7. Call 911 for immediate medical emergencies.
• You are aware that your daily inputs via the mobile app will be transmitted from the device to a secure HIPAA complaint data location. Your healthcare provider will safely and securely store your readings into their electronic medical records monthly.

Client Waiver

Simply stated, you understand that you are working with a Health Coach. The coach cannot be held liable for suggestions made within the visits, via the app and resources or education that are provided during your work together.

You have read and agree to the parameters of the coaching program which have been outlined on the previous pages.