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Life Coaching Consent

By signing this consent you are agreeing that you are aware of the HIPPA compliance guidelines that Driven2Inspire, LLC follows. Driven2Inspire, LLC is owned by Ebony McNichols, MSW,CAP. Driven2Inspire,LLC will not share any client's personal information, or information discussed in sessions. You agree that you understand that Driven2Inspire, LLC will take the necessary action to share your information in the event a safety concern is identified related to the client's well-being.


*You agree that you understand that life coaching is a collaborative effort that requires the client commitment, attendance to scheduled sessions, and open communication.

*Client understands that life coaching does not replace mental health therapy. In the event life coach identifies client requires mental health services, client will be redirected to appropaite services. 


*Client understands that owner has the right to discharge any client that is non adherent to the attendance policy or unable to impact through services provided.


*Driven2Inspire,LLC does not accept insurance at this time. All client's are considered self pay at this time.

*Client understand that all payments are non refundable. Client will be provided with up to two opportunities to reschedule session if unable to attend as schedule. No payment's will be refunded.

Do you agree that you have read the complete consent and agree to the guidelines of the life coaching consent.
Do you understand that all services are self pay at this time. Client is expected to make full payment when scheduling services. Driven2Inspire does not accept insurance at this time.

Thanks for submitting!

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