Family Life Coach Session

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"The mind is everything, what you think you will become.”
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you have an active/open Department of Child Safety Case?*

YesNo
Number of People in Session*
Your Spouse's Name & Child(ren)'s names/ages if applicable*
Please select a topic of discussion*
Note to Family Life Coach
Life Coaching Agreement
A Family Life Coach is NOT a therapist, or psychiatrist, therefore, coaches do not diagnose or tell a member how they need to handle a problem. A coach is a support directly to a member, helping a member get in touch with their inner spirit and help them to process their situation a lot clearer in order to find and create solutions to their current situations. A coach asks powerful questions allowing members to be empowered with choices and decisions for themselves. A coach will help members to get in touch with a peaceful place in order to think clearly about their situation without the clutter of the negative thoughts hindering a clear understanding of their crisis.*

I AgreeI DO NOT Agree
Our coaches will be prepared to understand signs of abuse, fear or mental challenges that may result in the need for further professional help. If a coach recommends a professional we will have the resources needed for the family that best fits their situation. SontarahLife WILL report all signs of child abuse, or neglect to Division of Children's Safety and Family Services, Adult Protective Services or peace officer IMMEDIATELY! If a Coach determines a member of the family is causing concern for the safety of other family members because of physical or mental abuse or showing signs of depression, anger, suicide etc. SontarahLife coaches will recommend the WHOLE family to a therapist.*

I AgreeI DO NOT Agree
By signing below you certify that You are at least 18 years of age. You have read this Life Coaching agreement and fully understand the contents thereof.*
Initial Intake Session Fee

Once payment has been received, a Family Life Coach will contact you to schedule your session.
Intake/Assessments are $50.00, afterward each coaching session is $100.00. Open and active Arizona Department of Child Safety (DCS) cases are $60.00 per sessions. Sessions are one hour with the initial intake being 45 minutes. At the end of every coaching session, the family will be asked if they would like to set another follow-up appointment with the Family Life Coach (FLC). All future appointments are at the family's discretion and may be recommended by the Family Life Coach. Most coaching sessions are held at our facility located at: 8900 N. Central Ave. #106. Our sessions can involve all family members, or any part of a family. Minors must have parent or guardian permission to receive coaching. Some sessions may be held over the phone but are left to the discretion of the FLC. *
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Initial Intake Session Fee$50.00
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Life Coaching Agreement

Initial Intake Session Fee