BREATH AS BELONGING 1:1
6-Week Coaching Agreement & Client Intake
This Agreement is made between BEHOLD Breath & Soul Coaching ("Coach") and the undersigned client ("Client"). By signing below, you confirm you have already agreed to enroll in the Breath as Belonging 1:1 6-week course and you are ready to begin.
What to Expect (6 weeks)
Session Structure
- Six (6) 1:1 sessions over approximately six weeks (scheduled by mutual agreement).
- Each session includes intention-setting, guided breathwork, integration, and next-step practices.
- You’ll receive simple between-session practices to support nervous system regulation and embodiment.
Your Support & Communication
- You can reach out between sessions for brief support and clarifying questions (response times vary; not crisis support).
- We’ll collaborate on pacing—this work is powerful and we honor your capacity.
- If you need to reschedule, please provide as much notice as possible.
What You May Experience
- Shifts in energy, emotion, and body sensations during or after sessions.
- Increased awareness of patterns, needs, boundaries, and inner resources.
- A deeper sense of belonging in your body—through breath, presence, and practice.
Client Agreement & Contract (signature required)
Please review this agreement carefully. By signing below, you confirm you understand and agree to the terms. (Your signature/contract form will appear here.)
Agreement Overview
This Coaching Agreement (the “Agreement”) is entered into between BEHOLD Breath & Soul Coaching (“Coach”) and the undersigned client (“Client”). This Agreement governs participation in coaching services offered by Coach.
1) Coaching Relationship
Coaching is a collaborative process intended to support personal insight, growth, and self-directed change. Coaching is not a substitute for medical care, psychotherapy, diagnosis, or treatment.
2) Client Responsibilities
Client is responsible for their choices, actions, and results. Client agrees to communicate openly, arrive on time for sessions, and complete agreed-upon practices between sessions.
3) Confidentiality
Coach will keep Client information confidential except where disclosure is required by law, where there is risk of harm to self or others, or where Client provides written permission to share.
4) Scheduling, Cancellations & Fees
Session timing, rescheduling, and payment terms are determined by the program or package selected. If Client needs to reschedule, notice should be provided as early as possible. Coach may charge for missed or late-cancelled sessions according to the applicable policy shared at booking.
5) Breathwork / Somatic Practices (If Applicable)
If Client participates in breathwork or somatic practices, Client agrees to listen to their body, pause or stop when needed, and seek appropriate medical guidance if they have any condition that may be impacted by these practices.
Client Acknowledgments (checkboxes required)
I understand coaching is not therapy and does not replace professional medical or mental health care.
I take full responsibility for my well-being, decisions, and actions during and after coaching.
I consent to participate fully and communicate honestly; I may stop any exercise at any time.
I have read and agree to the confidentiality and cancellation/payment terms described in this Agreement.
(Your required checkbox fields will appear here.)
6) Agreement & Signature
By signing below, Client confirms that they have read, understood, and agree to this Agreement. This Agreement becomes effective on the date signed.
Complete Your Payment
Use the secure checkout below to reserve your 6-week coaching container. If you have any questions before paying, email us at jess@beholdbreath.com.
Pay in Full
One payment today.
$___
- Secure checkout
- Receipt emailed instantly
- Reserves your start date
Pay in Full
By paying, you agree to the 6-week coaching agreement.
Payment Plan
Split into installments.
$___ / installment
- Secure recurring billing
- Flexible budgeting
- Reserve your start date
Start Payment Plan
Need a different arrangement? Contact us.
Secure payment • Your information is protected
Client Agreements (initial each)
Please initial next to each statement to confirm your understanding.
Coaching relationship
I understand this is a coaching container focused on breath, embodiment, and personal growth. It is not psychotherapy, medical care, or a substitute for professional mental health treatment.
Initials:
Personal responsibility
I am responsible for my own wellbeing during and between sessions. I will communicate honestly about my capacity, needs, and boundaries.
Initials:
Breathwork safety
I will inform the Coach of any relevant medical conditions, medications, pregnancy status, or mental health concerns that may impact breathwork. I understand I can pause, slow down, or stop at any time.
Initials:
Confidentiality
What you share in sessions is held in confidence, except where disclosure is required by law (for example, risk of harm to self/others or abuse reporting requirements).
Initials:
Attendance & rescheduling
I agree to attend sessions on time and to provide notice if I need to reschedule. I understand that repeated late cancellations may limit availability and continuity of care.
Initials:
Payment
I understand the program fee and payment plan (if applicable) have been agreed to separately, and I commit to completing payment as arranged.
Initials:
Note: If you are currently in therapy or under medical care, you are welcome here. Please continue working with your licensed providers as needed.
