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This is a new thing and like nothing you’ve ever done before, which is why it brings rapid, lasting results. In that spirit, complete this questionnaire quickly and indicate the first answer that comes to mind; try not to overthink your answers or say what you think the answer should be. Questionnaire is completely confidential and only your coach will see it. You will have the option to print your answers once filled in.

QUESTIONNAIRE

What is your current role/position in the business?

What specific outcomes have you identified for yourself as it pertains to this position over the next 3-6 months?

What specific outcomes has your organization or someone else given you?

What do you believe are your strengths in reaching these outcomes?

What are your current challenges in reaching these outcomes?

Is there a common pattern, underpinning these challenges?

How do these challenges impact your performance?

How will you know the challenges have been overcome?

To obtain the specific outcomes identified, a different perspective, ideas, and approach, and changes are necessary. Are you ready and willing to make changes to achieve your objectives?

Are you willing to be uncomfortable during the change process?

COACHING AGREEMENT

Please review this Coaching Agreement, sign where indicated, and return. It is important that you also review, acknowledge and agree to our Client Disclosure Form in connection with your engagement of Exponential Results.

Client Name:

How We Will Meet

Coaching sessions will be held via video conference or phone twice per month for 60 minutes per session, with action items and follow ups or check-ins in between. Ad-hoc meetings can be added as needed upon request to fully support your journey to Exponential Results.

Coaching Fee: $750/mo.

Payment

You may render payment by digital payment or monthly invoice. Payments are due on the 1st of the month in which service is rendered, and no later than in advance of any services to be performed in that month.

Please note that payment with any type of credit card will incur the applicable, state-allowable processing fee, which will be added to the total cost of services.

If you would like to pay via ACH, please fill out the fields below:

Bank Name:

Account Type (Checking/Savings):

Account Number:

Routing Number:

Expectations and Obligations for Coaching Sessions

Client Obligations. As the Client, you acknowledge and agree to the following:

1. Make coaching sessions a priority. In the event that you need to reschedule your coaching session, you agree to provide at least 24 hours advance notice. If less than 24 hours’ notice is provided, the session will be forfeited with no refund. Bona fide emergencies will be considered on an individual basis.

2. Changes/Cancellations. In the event that you need to reschedule due to unscheduled travel or similar, we ask for as much notice as possible, in consideration of the coaches schedule. Likewise, your coach may also need to reschedule a session on occasion. They will provide you as much notice as possible and try to make rescheduling as convenient as possible.

3. Payment for monthly sessions. Payments for all sessions shall be made in accordance with the terms in this Coaching Agreement. You agree to pay all amounts due in the manner specified herein.

4. Disclosure of Trauma or Mental Health concerns. You agree to disclosure any relevant trauma and mental health history, diagnosis, medication, concerns, or issues with your Exponential Results Coach at coaching engagement start.

5. Client Relationship and Use of Exponential Results’ Coaching tools. You agree to being a client of Exponential Results, which will directly engage the Coach to provide the agreed upon sessions and services to you. You shall not do anything to disrupt the relationship between Coach and Exponential Results without the prior consent of Exponential Results. You agree to communicate and use the coaching tools and applications provided by Exponential Results for all sessions and to seek assistance from the Coach or a specified Exponential Results administrative assistant if you have difficulty accessing any such systems.

6. Feedback. You are encouraged to provide feedback, if any, to your Coach or Exponential Results representatives during the coaching engagement. You also agree that representatives from Exponential Results may contact you occasionally to receive feedback or comments regarding the provision of services. If you provide suggestions, enhancement requests, recommendations, or other information regarding Exponential Results, including your coaching sessions, you agree to assign all rights, title and interest in such to Exponential Results, and all such feedback shall be deemed Exponential Results’ confidential information.

Coach Obligations. Coach and Exponential Results acknowledges and agrees to the following:

Confidentiality. The information you share with Exponential Results and your coach is confidential and Exponential Results and your coach will practice the highest industry standards to protect your confidentiality during the sessions. Your coaching sessions are personal to you and will not be shared with your employer or organization unless you direct otherwise. Exponential Results is committed to keeping your information confidential, and does not sell, rent, or lease contact information to third parties unless required by law.
Power Pathways Portal™. All coaching sessions, follow up, feedback, and scheduling will be conducted through an application authorized by Exponential Results. Currently, the authorized application is Power Pathways Portal™ (“PPP”). Your coach will ensure all session notes, scheduling, and other tools used for the sessions are communicated through PPP.

Disclaimer

Exponential Results’ liability to you for damages arising out of this agreement shall be limited to direct damages and shall not exceed the amount of fees paid by you within the thirty days prior to the event giving rise to the claim or causing the damages. Exponential Results shall have no liability whatsoever for special, incidental, exemplary, punitive, multiple, consequential, or indirect damages (including lost profits, loss of data, loss of use) of you or any third party, whether based upon warranty, contract, tort, strict liability or otherwise, even if you have been advised of the possibility of such damages. Exponential Results disclaims all warranties, express or implied, including but not limited to the implied warranties of merchanability, fitness for a particular purpose, title, and non-infringement.

Thank you

Thank you for entrusting Exponential Results with the opportunity to support you in coaching and to achieve your desired outcomes.

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Signed by Karen Brown
Signed On: July 6, 2022

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January 24, 2019 4:51 pm EDT

Get Started Monthly Maintenance Uploaded by Karen Brown - coaching@velocitylc.com IP 68.6.233.92