All coaching services, communication, email or otherwise, provided by Samantha Nielsen, (your “Coach”), are meant to help you identify areas in your life, thinking and nutritional practices which may be hindering your progress. Coaching is not professional mental health care nor a substitute for medical care. Coaching can augment therapy but is meant to be done when emotional and psychological states are highly functional. In that spirit, by purchasing coaching services, you confirm that you have read and agree to each statement and that you wish to proceed:

  • I understand that the coaching services I receive are not offered as a substitute for professional mental health care or medical care and are not intended to diagnose, treat or cure any mental health or medical conditions. I also understand that my Coach is not acting as a mental health counselor or a medical professional.


  • I understand that coaching is, at present, an unregulated industry and that my Coach, while certified by The Life Coach School, is not licensed in Arizona. 


  • I understand that I am fully responsible for my well-being during my coaching sessions, and subsequently.


  • I understand that all comments and ideas offered by my Coach are solely for the purpose of aiding me in achieving my defined goals. I have the ability to give my informed consent, and hereby give such consent to my coach to assist me in achieving such goals.


  • I understand that my Coach has not promised outcomes nor guaranteed results. My outcomes/results are completely dependent upon my level of commitment and effort.


  • I understand that my Coach will treat my information as confidential unless I provide permission otherwise.


  • I understand that the use of technology is not always secure, and I accept the risks of confidentiality in the use of email, text, phone, Zoom and other technology.


  • I hereby release, waive, acquit and forever discharge my Coach, from every claim, suit action, demand or right to compensation for damages I may claim to have or that I may arise out of acts or omissions by myself or by my Coach as a result of the advice given or otherwise resulting from the coaching relationship. This agreement shall be considered binding.


Client Signature:                                                                                        Date:                         

By signing and dating this document, I affirm that I have read and agreed to the statements noted above.                                    Additionally, I agree to provide an electronic copy, by email or photo text, of this agreement prior to initiating services.