About Kim Thomas

New Client Intake Forms

   Dear New Client: The following information will help us develop a rich relationship. Please fill out the personal information to the degree that you feel comfortable sharing the details. Once it’s complete, email this form back to me as an attachment. Your information will be held in confidence. Thank you!

Service Agreement




Service:
Kim Thomas Life Coach provides life coaching and mentorship services.

Payment:
Payments are to be made in full and prior to the start of any sessions or program.

Client Cooperation:
This Agreement contemplates full client cooperation in the course of services agreed upon. This cooperation includes clients agreement to remain active in the recommended programs subscribed by your life coach. The client recognizes that compliance with recommended services and service schedule is important and the client agrees to follow the plans implemented and carried out and agreed upon. The client understand that lack of cooperation, failure to keep appointments and engaging in activities identified by your life coach as potentially counterproductive to the program may necessitate additional sessions or termination of service. Our policy requires 48-hour advance notice for appointment cancellation. Failure to do so may result in deduction of pre-paid sessions.

Termination
The client may discontinue care or :terminate this agreement at any time by written notice or to that effect and delivered in person, or by mail to Kim Thomas Life Coach. Such “Notice of Termination” shall discharge Kim Thomas from all further obligations and agreements to render services to the client. Kim Thomas Life Coach reserves the right to terminate this agreement in its in its entirety at their discretion not withstanding any other terms or provisions of this agreement.

NO REFUNDS IN THE EVENT CLIENT TERMINATES AGREEMENT To encourage commitment and follow-through, Kim Thomas Life Coach offers no refunds. No refunds will be made on any services or sessions. There will be NO EXCEPTIONS. Prepaid sessions cannot be altered, shared or transferred, nor can it be combined with any other program.

Cancellations:
If there is a need to cancel for any reason, we ask for a 48-hour notice. Please Understand that when you do not cancel properly or no-show for scheduled sessions it incurs a cost to us. If you do not provide us with a 48-hour notice, or are a no show for your appointment, we may impose the following penalties:
• Loss of that session in your program package
• Loss of deposits or any advanced payments
• Any sessions paid in advance and have not been attended within 180 days will be discontinued.
• Same day cancellations will incur a loss of the scheduled session in your package or a $75.00 cancellation fee to be paid prior to your next scheduled session.

Client Also acknowledges and understands that Kim Thomas Life Coach is not a licensed therapist. you are responsible for all of your decisions, actions and feelings. I have read and understand the service agreement and agree to abide by the above conditions provided by Kim Thomas Life Coach
Yes
Yes
No
No

About Kim Thomas