Collaborative Neutral Family Consent Agreement

Collaborative Neutral Family Coach Consent Agreement(Required)
You are required to read through the following terms and conditions. When you have reach the end, checking the box will satisfy the agreement to be submitted.


The Collaborative Neutral Family Coach (Coach) and the Parent(s) enter into this contract voluntarily.


A. Role of the Family Coach: The Parties understand that the Coach’s role is to facilitate the process of reaching a settlement agreement as efficiently and productively as possible, while preserving the dignity and emotional well-being of each Party. It is the intent of the Coach to minimize the impact of the divorce on the family and create the most positive outcomes for both Parties. The Coach will create a neutral setting in which both parties contribute to agreements regarding each issue in the Collaborative divorce process. Additionally, the Coach will work with the parties to address parenting issues as needed.

The Coach is not authorized to give legal advice and will communicate with attorneys as necessary to avoid interfering in any legal process. The Coach is not serving in the role of a therapist. If the Coach determines that psychotherapeutic interventions would be helpful for the Parent(s), the Coach will make a referral to an appropriate therapist.

B. Role of the Parties: The Parties understand that their role is to answer the Coach’s questions as completely and honestly as possible, to engage to the fullest extent possible in the coaching process, to follow through with the positive strategies to the best of his/her ability, and to give feedback to the Coach as completely and honestly as possible regarding the coaching process and the implementation of the selected strategies.

C. Collaboration between Coach and Parties: The Parties understand that Coaching is a collaborative process in which the Coach and the Parties work together to co-create the Parties’ goals for the divorce, for parenting, for communication, for self-care and for the coaching process. Collaboration may take place between the Coach and each Party separately or with the Parties together.


A. Appointments: Appointments with the Coach shall be scheduled at the request of the Parties by phone, by email or in person. Coaching sessions may take place in person or over the telephone. Standard appointments are 60 minutes in length, and the Parties may request additional coaching over the telephone or by email.

B. Communication: The Parties may contact the Coach by telephone, email or text message. The Coach will make every effort to respond within 2 business days.

C. Confidentiality: All communications between the Coach and Clients may be disclosed at the discretion of the Coach if the Coach believes that the sharing of information will enhance, support and progress the collaborative divorce process. However, because this is a collaborative process, all communication is confidential within the parameters set forth for collaborative divorce. This means that the information used in this process may not be used in a court of law.  Either Client may request a conversation or meeting with the Coach without the knowledge or consent of the other client. If a client specifically instructs the Coach not to reveal something he/she wants to be held in confidence, the Coach and Client will need to discuss an agreeable resolution of the request. If the Coach determines that the information is important to the process, the Coach will advise the Client that the information needs to be disclosed.  Any sharing of information between the Coach and any other party outside of the collaborative professional team requires an authorization form signed by the Client giving written permission for a release of information.

D. Cancelled or missed appointments: The Parties shall pay in full for any cancelled or missed appointments unless 24-hour cancellation notice is given.


Fees for all appointments and meetings are $200.00 per hour. Fees for additional time spent in telephone or email conversations are billable at $200.00 per hour, calculated at 10-minute intervals. The Coach will notify the Parties before any charges are accumulated for telephone or email conversations. The Coach shall bill the Parties monthly with an itemized statement for telephone and email coaching.


Parties understand that the Coach is obligated under law to disclose the following information to appropriate authorities:

  1. allegations of abuse or neglect of a child,
  2. threats of harm to other people or yourself,
  3. statements made indicating plans to carry out or hide an ongoing crime, and
  4. statements made that reveal a felony crime.
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951 High Street Suite B Worthington, Ohio 43085