Date of Birth
* Date of Birth
What are 1-2 things that bring you joy to your life?
What's one of the main things you'd like to address during our coaching session?
How will you know whether that "thing" has shifted?
Please share any other information you think would be helpful for me to support you during the coaching process.
Coaching Fees and Time-frame
The first coaching session is $195 and will last approximately 2 1/2 - 3 hours. Each subsequent session will be $200 and will be approx 2 hours.
All payments are due within 24 hours of receiving coaching. A $50 fee will be applied for any payment received after 24 hours unless previously arranged with Veronica
A 24 hour advanced notice is required to cancel a coaching session. Cancellations less that 24 hours will still require full payment. Veronica understands that unforeseen emergencies occur and may choose to make an exception to this policy on a case by case basis.
Somatic Based-Coaching Approach
The coaching process includes a somatic approach and may trigger unprocessed/unexpressed emotions including traumatic experiences that are still present in the body. I, Veronica, will not ask you to share any specific trauma that has occurred, however, we may discuss the after-effects of the trauma and how it has impacted your relationships with self and others as well as behaviors, attitudes that have developed as a result of the trauma.
Acknowledgment that Veronica is a Coach and Not a Mental Health Professional
Veronica Clark uses a somatic/shamanic coaching approach in hopes that those she works with will live a more fulfilled life and rich life. I acknowledge that Veronica Clark is not a licensed physician or licensed mental health counselor and therefore does not diagnose or treat mental illness or disease. Furthermore, Veronica does not make recommendations regarding medical treatment or medications. I understand it is my responsibility to maintain a relationship for myself with a medical doctor if I have any concerns.
Friendship during the Coaching Relationship
Finding that you and your coach are a great fit is a beautiful feeling. It’s natural to feel an affinity and closeness towards one another. To maximize the results from the coaching relationship, it’s crucial to build a potent alchemical container where transformation at the highest level can occur. Therefore, personal friendships between the coach and coachee, outings, and any form of communication that lies outside of the agreed-upon coaching relationship will not be pursued by the coach. Once the coaching relationship has concluded, and a natural resonance is present, Veronica is happy to explore the possibility of an ongoing friendship.
I have read and understood the above disclosures. I will reach out to Veronica Clark with any questions or concerns I have prior to our scheduled session. 1. I represent and warrant that I am physically fit, and I have no medical conditions that would prevent my active, conscious participation in the coaching sessions with Veronica. 2. I also attest that I will take care of my body and honor any physical, emotional, and energetic limitations that may arise during our session. This means I will not overexert myself or push myself further than I can physically or emotionally go.
Because establishing clear and healthy boundaries is a vital part of our ongoing relationships in life, maintaining boundaries, between the coach (Veronica) and coachee (the one receiving coaching) during the coaching relationship is essential. Therefore the guidelines outlined in the coaching communication will be closely followed unless otherwise agreed to.
Thank you for taking the time to complete this form! I'm looking forward to starting this transformational journey with you!