Let’s get started! I’m so excited!

The next step: Fill out this form and then exhale! This is going to be grand.

Your preferred email address for me to contact you on.


To ensure we’re all on the same page (because nothing is worse than signing up and then being surprised!) here is a run down of what we’re both committing to:

Role of Mentor

∞     Be non-judgmental, objective & open throughout the coaching process.

∞     Focus on the goals of the client.

∞     Encourage and challenge the client, teaching skills as required.

∞     Observe confidentiality of all discussions at all times unless there is a potential for, or a risk to beings, the organization or the law.

∞     All records and information resulting from the sessions will be kept confidential except as required by law.

Role of Client

∞     Prepared to take on board feedback received.

∞     Open to challenges to thoughts, ideas, and working practices.

∞     Commit to the principles of mentoring to aid development.

∞     Fully responsible for their own physical, mental and emotional wellbeing during sessions, including choices and decisions made. 

∞     Can choose to discontinue coaching at any time, although no refund shall be issued.

This section defines how sessions will be conducted by both mentor and client.

∞     To communicate honestly and openly at all times.

∞     Neither mentoring nor coaching involves the diagnosis or treatment of mental health conditions, and is not a substitute for therapy. Equally, these sessions are not a substitute for professional advice by legal, medical, financial, business, spiritual or other qualified professionals.

∞     Both the mentor and client agree to give at least 24 hours notice if unable to attend a one-to-one session, or as much notice as possible in the event of illness or an emergency.


I agree to all terms and statements above, and it is my intent, to indicate agreement by typing my name and electronically submitting this record/document.

I understand that my submitting this record/document in this fashion is the legal equivalent of having placed my handwritten signature on the submitted record/document and this affirmation.

I understand and agree that by submitting this record/document in this fashion I am affirming to the truth of the information contained therein.

Effective: March 22, 2019


It’s time to craft your 'new normal' & be your own eff'ing hero. Ready?Count Me In! →