Erica Ballard Health's Couple Program Agreement
Welcome! During the coming weeks, you will learn ways to help yourselves achieve a healthier diet and lifestyle. Please read the following. If anything is unclear, please ask.
This Agreement is made today between Erica Ballard, the coach of the program and you, the Clients. The Program in which you are about to enroll in will include all of the following:
- Two sessions Health Blueprints, which includes:
- 75-minute assessment of your current diet, lifestyle, concerns, and goals
- Five-day food journal review (to be returned within 24 hours of session)
- Full health history analysis (questionnaire to be filled out 24 hours prior to session)
- Recommendation of top 1-3 diet or lifestyle changes to significantly address your health concerns and move you towards your goals
- EBH food journal to track you progress following the Blueprint
- Pantry Check and Build, which includes a 75 minute onsite visit at your house to:
- Discuss blueprint findings and outline ways to work together to achieve your individual health and wellness goals
- Review of your fridge and pantry to clean out the kitchen clutter and create a pantry/fridge staple list unique to you and your family's preferences and goals
- Tailored resources, tools, and gifts, which could include recipes, food journals, meditation guides, following each Blueprint and the Pantry Check
As your Coach, I understand that my clients have busy schedules, and I take pride in not keeping them waiting or keeping them longer than planned. Each session will end 75 minutes after it was scheduled to begin. Please be on time. If the Client(s) is late to the appointment, the session will not be extended. If the Client(s) needs to cancel or reschedule the appointment, the Client(s) can reschedule one appointment at no cost. Additional rescheduling will incur a cost. However, the cancellation must occur 24 hours in advance; otherwise, the Client(s) will forfeit that appointment and will not have an opportunity to reschedule it.
PAYMENTS AND REFUNDS
The Client(s) agrees to this initial couple's coaching package at $1,200 for three session (2 individual and 1 joint). In the event of the Clients' absence or withdrawal within 24 hours of the appointment, for any reason whatsoever, the Client(s) will remain responsible for the pro rata share of the program that has been delivered, plus a cancelation fee of $50. As outlined above, the Clients may reschedule one appointment. Additional reschedules will incur a fee of $100. Client(s) may pay through MoonClerk. Client(s) grants Erica Ballard the authority to charge the card. Client(s) is responsible for full payment of the program. No refunds will be issued.
COMMUNICATION BETWEEN SESSIONS
The Coach will communicate with the Client(s) between sessions via email. Clients can reasonably communicate with the Health Coach between sessions email. The Coach will response to emails within 72 hours, unless she is out of office or otherwise noted. If the Client(s) does not adhere to the communication policy, the Coach reserves the right to cancel the program.
The Client(s) understands that the role of the Health Coach is not to prescribe or assess micro- and macronutrient levels; provide health care, medical or nutrition therapy services; or to diagnose, treat or cure any disease, condition or other physical or mental ailment of the human body. Rather, the Coach is a mentor and guide who has been trained in holistic health coaching to help clients reach their own health goals by helping clients devise and implement positive, sustainable lifestyle changes. The Client(s) understands that the Coach is not acting in the capacity of a doctor, licensed dietician-nutritionist, psychologist or other licensed or registered professional, and that any advice given by the Coach is not meant to take the place of advice by these professionals. If the Client is under the care of a healthcare professional or currently uses prescription medications, the Client(s) should discuss any dietary changes or potential dietary supplements use with his or her doctor and should not discontinue any prescription medications without first consulting his or her doctor.
The Client(s) has chosen to work with the Coach and understands that the information received should not be seen as medical or nursing advice and is not meant to take the place of seeing licensed health professionals.
PERSONAL RESPONSIBILITY AND RELEASE OF HEALTH CARE RELATED CLAIMS
The Client(s) acknowledges that the Client(s) takes full responsibility for the Clients' life and well-being, as well as the lives and well-being of the Clients' family and children (where applicable), and all decisions made during and after this program.
The Client(s) expressly assumes the risks of the Program, including the risks of trying new foods or supplements, and the risks inherent in making lifestyle changes. The Client(s) releases the Coach from any and all liability, damages, causes of action, allegations, suits, sums of money, claims and demands whatsoever, in law or equity, which the Client(s) ever had, now has or will have in the future against the Coach, arising from the Clients' past or future participation in, or otherwise with respect to, the Program, unless arising from the gross negligence of the Coach.
The Coach will keep the Clients' information private and will not share the Clients' information to any third party unless compelled to by law.
ARBITRATION, CHOICE OF LAW, AND LIMITED REMEDIES
In the event that there ever arises a dispute between Coach and Client(s) with respect to the services provided pursuant to this agreement or otherwise pertaining to the relationship between the parties, the parties agree to submit to binding arbitration before the American Arbitration Association (Commercial Arbitration and Mediation Center for the Americas Mediation and Arbitration Rules). Any judgment on the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof. Such arbitration shall be conducted by a single arbitrator. The sole remedy that can be
awarded to the Client(s) in the event that an award is granted in arbitration is refund of the Program Fee. Without limiting the generality of the foregoing, no award of consequential or other damages, unless specifically set forth herein, may be granted to the Client(s).
This agreement shall be construed according to the laws of the State of Indiana. In the event that any provision of this Agreement is deemed unenforceable, the remaining portions of the Agreement shall be severed and remain in full force.
If the terms of this Agreement are acceptable, please sign the acceptance below. By doing so, the Client(s) acknowledges that: (1) he/she has received a copy of this letter agreement; (2) he/she has had an opportunity to discuss the contents with the Coach and, if desired, to have it reviewed by an attorney; and (3) the Client(s) understands, accepts and agrees to abide by the terms hereof.