ABIDE & Rise

Initial Coaching Qualification

Complete this short form before scheduling your consultation.

It is not a replacement for therapy.

This brief questionnaire helps determine whether coaching is the best support for you at this time. Coaching focuses on forward growth, accountability, and practical tools.

What brings you to coaching at this time? (Briefly share what you are hoping to gain.)

Which best describes your current focus? (Select one)Gaining clarity and directionPersonal growth and mindset shiftsAccountability and goal-settingFaith-based encouragement and balanceHealing from emotional pain or past trauma

Are you currently experiencing emotional distress that significantly interferes with your daily life? (Examples: frequent panic, inability to function, overwhelming sadness, emotional numbness)YesNoUnsure

Are you currently working with a licensed therapist or counselor?YesNoPlanning to start soon

Have you recently been advised by a professional to seek therapy or mental health treatment?YesNo

Coaching requires personal responsibility and forward action. How ready do you feel to engage in that process right now? Scale: 1 (not ready) – 10 (very ready)

Do you currently have a support system outside of coaching? If so, who? (Friends, family, church, mentor, etc.)YesSomewhatNo

Is there anything else you feel is important for me to know before determining next steps?

Coaching Disclaimer & Acknowledgment

I understand that coaching is a forward-focused, growth-oriented process and is not therapy, counseling, or mental health treatment. Coaching does not diagnose, treat, or heal mental health conditions or trauma.

I understand that if it is determined that therapy would be a more appropriate support at this time, I may be referred to a licensed mental health professional. This referral is made with care and with my well-being as the priority.

By submitting this form, I acknowledge that:

I am responsible for my own emotional and mental health
Coaching focuses on present and future growth, not trauma processing
Coaching is not a substitute for therapy or medical care

Client Signature (Type Name) *

Date

ABIDE & Rise

Restoring Connection & Peace

Couples Application

Thank you for taking this step. Your individual responses help ensure that both partners feel heard, understood, and supported throughout the coaching journey.

Client Agreement

Part 4 of 4: Mandatory

Purpose of Coaching

Coaching is a collaborative, goal-oriented process designed to support the client in areas including, but not limited to, personal growth, emotional awareness, relational clarity, mindset development, accountability, and practical life application.

Coaching is forward-focused and action-based. It is intended to help the client gain insight, develop tools, and make empowered decisions aligned with their goals and values.

Coaching is not therapy, counseling, psychological treatment, or medical care.

Scope of Practice

The Coach does not diagnose, treat, prevent, or cure mental health conditions, trauma disorders, or medical issues. Coaching does not replace the services of licensed mental health professionals, medical providers, or pastoral counselors.

If at any time the Coach believes the client would benefit from professional therapy, medical care, or other licensed services, the client agrees to seek such support. The Coach may pause or discontinue coaching if it falls outside the Coach’s scope of practice.

Client Responsibility

The client understands that coaching is a partnership and that results depend largely on the client’s honesty, commitment, effort, participation, and follow-through between sessions.

They are responsible for their own choices, actions, and results
Coaching may involve emotional discomfort as growth, self-reflection, and change occur
The Coach does not guarantee specific outcomes

The Client agrees to communicate openly, arrive on time, complete agreed-upon exercises or reflections, and engage respectfully in the coaching process.

Confidentiality

All coaching conversations, records, and communications are kept strictly confidential. Exceptions to confidentiality include:

Disclosure required by law or court order
Situations involving suspected abuse or neglect of a child, elder, or vulnerable person
Situations where there is a credible risk of imminent harm to the Client or others

The Coach may seek guidance from a professional mentor or supervisor to provide the best possible coaching. Your name and identifying information will always be kept private.

Payment Policy

Payment is required in advance for all individual sessions and coaching packages.
Coaching packages must be paid in full unless otherwise agreed upon in writing.
Accepted payment methods will be communicated prior to booking.
Failure to submit payment may result in session cancellation or suspension of services.

Cancellation & Rescheduling Policy

A minimum of 24 hours’ notice is required to cancel or reschedule a session.
Late cancellations (less than 24 hours) and no-shows will be charged in full.
Emergencies may be considered on a case-by-case basis at the Coach’s discretion.

Refund & Expiration Policy

Single sessions and coaching packages are non-refundable once coaching has begun.
Unused sessions within a package must be used within three (3) months of purchase unless otherwise stated in writing.
Sessions not used within the expiration period are forfeited.

Liability Disclaimer

Coaching is not a substitute for therapy, counseling, or medical treatment
The Coach is not responsible for the Client’s decisions, actions, or outcomes
The Client assumes full responsibility for their participation in coaching and any resulting outcomes

By entering into this Agreement, the Client releases the Coach from any liability related to decisions or actions taken by the Client during or after the coaching relationship.

Faith-Based Disclosure

Coaching may include faith-based perspectives, biblical principles, or spiritual reflection only if welcomed and consented to by the Client. Coaching services are respectful of the Client’s beliefs, values, and boundaries.

Faith-based elements are optional and client-led.

Termination of Coaching

Either party may terminate the coaching relationship at any time with written notice. No refunds will be issued for sessions already completed or packages already in progress.

The Coach reserves the right to terminate coaching if:

The Client violates this Agreement
Coaching is no longer within scope
The relationship is no longer productive or respectful

Acknowledgment & Agreement

Full Legal Name

Date

ABIDE & Rise

Student Parent/Guardian Permission,

Youth Name: *

Age

Parent/Guardian Name: *

Phone Number: *

Email Address: *

Emergency Contact: *

Purpose of Youth Coaching

Abide & Rise Relationship & Mindset Coaching is designed to support personal growth, mindset development, emotional awareness, confidence-building, and (when selected) faith-based encouragement. Coaching is intended to provide a safe, supportive environment where youth can express themselves, learn healthy coping skills, and grow in self-awareness.

Coaching vs. Therapy (Important Distinction)

Youth Coaching is NOT therapy.

Coaching focuses on personal growth, mindset, goals, emotional awareness, values, and encouragement.
Coaching does not diagnose, treat, or heal mental health conditions.
Coaching does not replace therapy, counseling, or medical care.

Therapy addresses:

Mental health diagnoses (anxiety disorders, depression, trauma, self-harm, etc.)
Clinical treatment and emotional processing
Past trauma requiring professional mental health care

If therapy support is needed, I am still able to offer coaching if you are receiving therapy support. Coaching and therapy can be a powerful partnership in personal growth.

Safety & Ethical Protocols

Confidentiality is respected; however, confidentiality cannot be maintained if a youth discloses: Self-harm or suicidal thoughts, Abuse (physical, emotional, sexual), or Harm toward others. In these cases, the parent/guardian and appropriate authorities will be notified as required by law.

If a youth is currently experiencing severe emotional distress, self-harm, suicidal thoughts, abuse, or trauma, a licensed mental health professional is required. In such situations, and when the youth and family are part of Wellspring Church, Youth Pastor Connor will be informed to ensure appropriate care, safety and coordinate support.

Faith-Based Coaching (Optional)

Faith-based coaching is always gentle, optional, and never forced. If selected, it may include prayer, biblical encouragement, scripture-based reflection, and discussions centered around identity and purpose through a Christian lens.

Parent Involvement & Communication Consent

By signing this form, parents/guardians understand that parents are partners in the coaching process and communication with parents is part of maintaining safety and accountability.

Parents consent to the following:

All communication will go through parents or church-approved platforms.
The coach may contact parents regarding attendance, behavioral concerns, safety issues, or general progress.

Parents understand that:

Coaching conversations are private, not secret.
Personal details shared by the student will be respected.
Parents and church leadership will be informed if there are concerns involving safety, abuse, or mandatory reporting

Parent/Guardian Consent to Communicate

By signing below, I give consent for the coach to communicate with me regarding my child’s participation in the Youth Coaching Program according to the guidelines above.

Parent Signature (Type Name)

Date

Student Commitment

I understand what is expected of me in this program and agree to participate respectfully, consistently and honestly. In group sessions I agree to keep what we share in group sessions private. This means no mocking, laughing at others, shaming, being mean or dismissive. If I do not follow these rules, I understand that I will be removed from the course.

Parent Signature (Type Name)

Date

Student Commitment

I understand what is expected of me in this program and agree to participate respectfully, consistently and honestly. In group sessions I agree to keep what we share in group sessions private. This means no mocking, laughing at others, shaming, being mean or dismissive. If I do not follow these rules, I understand that I will be removed from the course.

Student Signature (Type Name)

Date

ABIDE & Rise

Parenting Support Application