Coaching Intake | The Fat Psychologist

Coaching Intake Form

Please fill this form ahead of our first coaching session.
Complete as many questions as you can, as they will help us both prepare for our meeting.

Name*

Last name*

How do you prefer to be called?

What are your preferred pronouns?

Email*

What prompted you to seek coaching at this time?*

If coaching were successful for you, what would be different in your life?

Have you worked with a coach before? If so, what worked well? What didn’t?

Are there any values or principles that are especially important to you ini this process?

Is there anything about your lived experience (e.g., neurodivergence, marginalisation, cultural background) that you’d like me to be aware of as your coach?

What is your chosen fee level?*

Full fee: £350 per hour or £1800 per 6 hour block booking

Pay it forward fee: £400 per hour or £2100 per 6 hour block booking

Reduced fee: £175 per hour or £900 per 6 hour block booking

Community fee: £40 per hour - you will need to fill an application form

Is there anything else you’d like me to know before we begin?

Thank you for completing the intake form. Please book your next session using this link.

Coaching Agreement

After you complete the coaching intake form and before starting our first session, I will also ask you to sign a coaching agreement, please check your email. You can read the general terms here.

1. Purpose of Coaching

Coaching is a collaborative process designed to support personal and/or professional growth. It is not therapy, counselling, or medical treatment. As your coach, I will support you in clarifying goals, exploring challenges, and building strategies aligned with your values.

2. Scope of Services

Sessions will be conducted online via Microsoft Teams.
Each session lasts 60 minutes, scheduled at mutually agreed times.
Coaching may include reflective exercises, goal-setting, and strategic planning.
I do not diagnose or treat mental health conditions. If such support is needed, I may recommend seeking a qualified therapist.

3. Confidentiality

All information shared during coaching sessions will be treated as confidential, except where disclosure is required by law (e.g., risk of harm). I adhere to UK GDPR standards and will never share your data without consent.

4. Fees & Payment

Coaching fees are set according to the pricing strategy set on my website. [The agreed payment level will be included in your individual agreement].
Payment is due before each session.
Cancellations require 24 hours’ notice. Late cancellations may be charged at full rate.

5. Client Responsibilities

You agree to engage in the coaching process with honesty and openness.
You are responsible for your own decisions, actions, and outcomes.
Coaching is most effective when you commit to reflection and follow-through between sessions.

6. Coach Responsibilities

I will provide a respectful, inclusive, and empowering space.
I will honour your lived experience and support your goals without judgment.
I will maintain professional boundaries and refer out if coaching is no longer appropriate.

7. Termination & Review

Either party may end the agreement with 5 days’ notice.
We will review progress periodically to ensure coaching remains aligned with your needs.

8. Legal Jurisdiction

This agreement is governed by the laws of England and Wales. Any disputes will be resolved under UK jurisdiction.

The fat Psychologist

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The contents of this website present my opinions and not those of any organisations I am affiliated to. They are not intended to provide healthcare advice, but to help all of us make evidence based decisions on our wellbeing. Each of us is unique, evaluate for yourself if any of my opinions resonate with your experience. Any other contributors to the website or podcast are also expressing their personal opinions.

I have been careful to be respectful and accurate in sharing my views. However, I recognise I am human and can make mistakes. If you spot an error or have a comment, please let me know through my contact form.

I share stories, many from my own life. In doing this, I balance openness with confidentiality. I am careful in navigating the boundaries between confidentiality, attributing the contributions of others, and keeping secrets when a story is not fully my own. If in doubt, I will err in the side of caution. If I have not done this appropriately with your own story, please contact me directly so I can correct my mistake. This might include, for example a request that I attribute your story when I shared it using a pseudonym.

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