Inner Alignment Coaching Intake Form

Please be as specific as possible and submit before the start of our initial session. If you have any questions or concerns, you can email me, or we can discuss during our inital session.
I am so very grateful you are here! See you soon. 

SPIRIT SPRINGS HOLISTIC HEALING, LLC

INNER ALIGNMENT COACHING AGREEMENT

Coach: Cherrielee Slead, MS, LMHCA

Purpose of Coaching

Coaching is a collaborative partnership designed to support personal growth, self-awareness, goal achievement, mindset development, and overall well-being. Coaching is future-focused and intended to help clients identify obstacles, build on strengths, and create meaningful change.

Client and Coach Responsibilities

The Coach agrees to:

• Provide a supportive, nonjudgmental environment.

• Offer guidance, feedback, tools, and accountability.

• Maintain professional boundaries and ethical standards.

The Client agrees to:

• Participate actively and honestly in the coaching process.

• Take responsibility for personal choices, actions, and outcomes.

• Communicate openly regarding goals, concerns, and feedback.

Nature of Coaching Services

The Client understands and agrees that coaching:

• Is not psychotherapy, counseling, mental health treatment, or substance use treatment.

• Does not diagnose or treat mental health disorders.

• Is not a substitute for medical, psychiatric, legal, or financial advice.

• Does not guarantee specific outcomes or results.

The Client understands that although the Coach is a licensed mental health professional, coaching services are separate and distinct from mental health counseling.

Confidentiality

The Coach will make every reasonable effort to maintain the privacy of information shared during coaching sessions.

The Client understands that coaching services do not carry the same legal protections as psychotherapy.

The Coach is a mandated reporter and may be required to disclose information if:

• There is suspected abuse, neglect, or exploitation of a child or vulnerable adult.

• There is a serious threat of harm to self or others.

• Disclosure is otherwise required by law.

Communication Between Sessions

Email, text messaging, and phone communication are intended for scheduling and brief coaching-related communication.

Extensive coaching support outside of scheduled sessions may require an additional appointment and fee.

Not Crisis Services

Coaching services are not crisis services.

If the Client experiences a mental health emergency, suicidal thoughts, thoughts of harming others, or any situation requiring immediate intervention, the Client agrees to contact 911, 988, a local crisis line, or visit the nearest emergency room.

Termination

Either party may terminate the coaching relationship at any time.

The Coach reserves the right to terminate services and/or provide referrals if the Client's needs exceed the scope of coaching services or if coaching is no longer clinically or ethically appropriate.

Acknowledgment

I have read and understand this Coaching Agreement. I understand the nature and scope of coaching services and voluntarily agree to participate.

SPIRIT SPRINGS HOLISTIC HEALING, LLC

PRACTICE POLICIES & FINANCIAL AGREEMENT

Appointments

Sessions are scheduled for approximately 50–55 minutes unless otherwise arranged.

Clients are encouraged to arrive on time. Sessions will begin and end at the scheduled time.

Late Arrivals

If the Client arrives late, the session may be shortened accordingly.

Clients arriving more than 15 minutes late without prior communication may be considered a no-show.

Fees

Session Fee: $__125__

Payment is due at the time of service unless other arrangements have been made in advance.

Accepted payment methods include Zelle, Venmo, Square, or other approved payment methods.

Refund Policy

Fees for completed services are non-refundable.

Cancellation Policy

A minimum of 48 hours notice is required to cancel or reschedule an appointment.

Appointments canceled with less than 48 hours notice will be charged the full session fee.

Missed appointments (no-shows) will be charged the full session fee.

Exceptions may be made at the discretion of the practice for emergencies or unforeseen circumstances.

Credit Card on File Authorization

The Client agrees to maintain a valid payment method on file through Square or another secure payment processor utilized by Spirit Springs Holistic Healing, LLC.

The Client authorizes Spirit Springs Holistic Healing, LLC to charge the payment method on file for:

• Late cancellation fees

• No-show fees

• Outstanding balances for services rendered

All late cancellation and no-show charges will include an additional 5% processing fee to cover payment processing costs.

The Client may update payment information at any time by notifying Spirit Springs Holistic Healing, LLC.

Telehealth

Virtual sessions may be conducted through the Zoom platform.

Clients agree to participate from a location that provides reasonable privacy whenever possible.

Technology disruptions may occasionally occur. Reasonable efforts will be made to reconnect or reschedule if necessary.

Communication

Email, text messages, and voicemail are intended for scheduling and administrative purposes.

These communication methods are not appropriate for emergencies or urgent mental health concerns.

Response times may vary and are typically within 1–2 business days.

Social Media & Professional Boundaries

To maintain professional boundaries and protect client privacy:

• Friend requests from current clients on personal social media accounts may not be accepted.

• Public interactions on social media do not imply a professional relationship.

• Client confidentiality will be protected at all times.

Acknowledgment

I have read, understand, and agree to abide by the policies outlined above.