MiracleEnterprises.net - Legal

Donna Christensen
Wellness Coach
Specializing in Lifestyle Strategies for Weight Management

Informed Consent Form

The undersigned hereby gives informed consent to engage in the coaching process. I recognize that it is my responsibility to provide accurate information during discussions and that this information is held in strict confidence.

This information will only be disclosed with my written permission with exceptions including, subpoena, in cases of current child abuse, or if there is an expressed intent to harm myself or another person.

I understand that I have the right in coaching to self-disclose what I choose and that any action based goals that are set in the nutrition, physical activity, and stress management realm are of my choosing and are entered into with my consent.

I recognize that it is my responsibility to monitor my individual performance in these areas and will seek the help of professionals should any problems arise. In the event of a medical problem, I further recognize that any medical care that may be required is my personal financial responsibility.

Signed: _______________________________________ Date: _________________

Adobe PDF copy of the form - Cooper Informed Consent Form.