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Mental Wellness Coaching Agreement

This Coaching Agreement (“Agreement”) is entered into by and between:

Coach: Maxine Chi-Chi Okafor

The Perfect Prescription LLC (DrChiChiRx)

Contact: 323-568-1700, support@theperfectrx.com, drchichirx.com


and

CLIENT INFORMATION

Birthday
Month
Day
Year

Whereby Coach agrees to provide coaching services to Client based on the terms and conditions outlined below.

1) Description of Coaching

Coaching is a collaborative partnership between the Coach and Client. It is a thought-provoking and creative process that inspires clients to maximize their personal and professional potential. Coaching is distinct from medical or mental health services, including counseling, psychotherapy, or diagnosis of any medical conditions.


Client understands that coaching is not therapy, does not substitute for mental health treatment, and does not involve the use of any nursing or medical practice license. The Coach’s qualifications, including her Doctorate in Nursing Practice, permit her to engage in wellness coaching, but this Agreement is not for clinical services.


2) Coach-Client Relationship

A. Ethical Standards: The Coach adheres to the ethics and standards established by the International Coach Federation (ICF). Clients are encouraged to review these standards at coachfederation.org/ethics.


B. Client Responsibilities:Client is responsible for their own physical, mental, and emotional well-being, as well as the decisions, actions, and results arising from the coaching relationship. The Coach is not liable for any outcomes resulting from the coaching sessions, nor will the Coach offer legal, financial, or medical advice.


C. Termination:Either party may terminate the coaching relationship with 24 hours written notice.


D. Client’s Acknowledgement:The Client acknowledges that coaching is a comprehensive process that may involve different aspects of life such as work, finances, health, and relationships, and accepts full responsibility for applying coaching principles to those areas. Coaching does not involve diagnosis or treatment of mental disorders and is not a substitute for professional mental health care or other qualified professional advice. It is recommended that Clients seeking mental health care promptly inform their care providers of the coaching relationship.


E. Client’s Commitment:The Client agrees to communicate openly and honestly, be open to feedback, and fully participate in the coaching process by creating the necessary time and energy for the sessions.


3) Services and Scheduling

A. Coaching Program. Sessions may be held via the following methods:

  • In-person

  • Online via secure video conferencing (Zoom or equivalent)

  • Phone


B. Scheduling:Sessions are scheduled online at drchichirx.com, by calling 323.568.1700, or by emailing support@theperfectrx.com.Any rescheduling requests must be submitted 48 hours in advance, or the session will be forfeited. A $50 reschedule fee will apply to the next appointment.


C. Additional Time:Additional time outside of normal sessions may be available at a prorated rate of $100 per hour, payable in advance.


4) Fees and Payments

This Agreement is valid as of the date payment is received. The fee is dependent on the specific coaching service selected and will be detailed in the service agreement.

  • Session Length: Sessions may vary in length depending on the service, ranging from 30 minutes to 120 minutes.

  • Payment Terms: All payments are due in advance unless otherwise agreed. If the program is discontinued, any refunds will be at the sole discretion of the Coach.


5) Confidentiality

The coaching relationship, as well as all information shared by the Client with the Coach, is confidential, subject to certain exceptions as required by law or as set forth below. Information will not be disclosed without written consent, except in situations where the Coach believes there is an imminent threat of harm to the Client or others, or where disclosure is required by law (e.g., by subpoena or court order).

Confidentiality does not cover:

  • Information generally known to the public

  • Information obtained from third parties without breach

  • Instances involving illegal activity

7) Cancellation Policy

The Client agrees to provide 48 hours’ notice for any cancellations or rescheduling of sessions. Failure to provide sufficient notice will result in forfeiture of the session and the application of a $50 rescheduling fee for the next appointment.


8) Limited Liability

Except as expressly stated, the Coach makes no guarantees or warranties regarding the outcome of the coaching relationship. Under no circumstances shall the Coach be liable for indirect, consequential, or special damages arising from the coaching relationship. In any case, the Coach's total liability shall be limited to the amount paid for the services.


9) Dispute Resolution

In the event of a dispute that cannot be resolved amicably, the parties agree to seek mediation in good faith for a period of 30 days. If the matter is not resolved, the prevailing party in any legal action shall be entitled to recover legal fees and costs.


10) Severability

If any provision of this Agreement is found to be invalid or unenforceable, the remainder of the Agreement shall remain in effect. The invalid provision shall be adjusted to make it enforceable or removed entirely.


11) Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of California for domestic clients or relevant international laws for clients abroad.


12) Entire Agreement

This Agreement represents the entire understanding between the parties. It supersedes any prior written or oral agreements. Modifications to this Agreement must be made in writing and signed by both parties.

Please sign and return a copy of this Agreement prior to the first scheduled coaching session.

Opening Hours

Mon, Tues, Friday

10:00 am – 5:30 pm

Virtual, In-Person, and Home Visits are available. Please note that In-Person and Home Visits are by appointment only, and payment terms may vary for home visits.

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