Confidentiality Policy Please read and initial each statement below Name * First Name Last Name I understand that all information obtained in the course of my coaching services are confidential unless there is a compelling professional or legal reason for its disclosure. * I understand that my Coach will disclose confidential information without a specific release as required by law or if the confidential information may put me or others at risk of harm or compromise their well-being. For example, if I report child, elder abuse or neglect or threaten to harm myself or someone else, I understand that necessary actions will be taken and my confidentiality agreement will be limited. * I understand that my Coach may disclose confidential information without my consent as mandated or permitted by law. * I understand that if my Coach is ordered by a court to provide information or to testify, he or she will do so to the extent required by the law. * I understand that my Coach will not disclose confidential information to third parties unless I give written permission that it be shared. * I understand electronic communications include, but are not limited to, emails, text messages, video conferencing, and voicemail and that the confidentiality of electronic communications cannot be guaranteed. * I understand that by communicating with my Coach via electronic communications I am implicitly consenting to these communication methods despite their vulnerability and insecurity, and I understand that they may result in the unintentional harmful disclosure of personal information. * By signing below, I agree to the following: I have read and understood the confidentiality agreement. I agree to waive all liability toward my Coach and Ember Coaching and Consulting, LLC for any injury, losses, or damages incurred as they relate to this agreement. * Thank you!
