This agreement outlines the coaching relationship with Miss Sarah – The Mindful Eye. Parenting
coaching is a collaborative, mindful process focused on awareness, growth, and skill development.
Coaching is not therapy, diagnosis, or medical care.

By filling out this Intake Packet and digitally signing below, you acknowledge that you understand and agree to the coaching boundaries, confidentiality limits, cancellation and payment policies, and scope of practice. You understand that you are fully responsible for your parenting choices and actions.

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Presenting Concerns
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Goals for Coaching
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Coaching Packages (select one)
 $60 / hour (single session)
 2-week package – $120
 3-week package – $180
 4-week package – $240
I understand that parenting coaching is not therapy, counseling, psychotherapy, or medical treatment. The coach is not a licensed mental health professional, medical provider, or healthcare practitioner under Massachusetts law. Coaching does not diagnose, treat, or prevent any mental, emotional, or physical condition. If I or my child require medical, psychological, or psychiatric services, I agree to seek care from a qualified licensed professional.
Confidentiality: All information shared in coaching sessions is kept confidential except as required by Massachusetts law, including but not limited to suspected abuse or neglect of a child, elder, or
vulnerable person, or when disclosure is required by court order.
Scope of Practice: Coaching focuses on parenting education, skill-building, mindset, and support. It does not include diagnosis, treatment of mental health disorders, legal advice, or crisis intervention.
Cancellations: A minimum of 24 hours’ notice is required to cancel or reschedule sessions. Sessions canceled with less notice may be charged in full, except in emergencies.
Payment: Payment is due prior to or at the time of service unless otherwise agreed upon in writing.
Missed sessions may not be refunded.
By signing below, I acknowledge that I have read, understand, and agree to these coaching terms and policies.