For Individuals

New Client Intake Form

Please answer the following questions to the best of your ability. Your responses help guide the coaching process and ensure a tailored experience. All information provided is kept confidential, following the same standards as our sessions.

Before completing this intake form, please review the Consent to Consultation Agreement below. Your submission confirms your acknowledgment and agreement to its terms.

CONSENT FOR CONSULTATION AGREEMENT

Kaizen Catalyst | Sports & Performance Psychology Coaching

1. Nature of Services

Kaizen Catalyst provides sports and performance psychology coaching designed to enhance mental skills such as focus, confidence, resilience, and stress management. These services are based on scientific principles and research-backed strategies, but they do not constitute therapy, counseling, or medical treatment.

Performance coaching is goal-oriented and skills-based, focusing on optimizing mental performance in sports, business, and other high-performance domains. It is not intended to diagnose, treat, or cure mental health conditions.

2. Confidentiality & Limits

All personal information shared during sessions will remain confidential, except in the following circumstances:

  • If there is a risk of harm to yourself or others, Kaizen Catalyst may take appropriate action, including contacting emergency services.

  • If disclosure is required by law, such as in cases of abuse, neglect, or a court order.

  • If you provide written consent for information to be shared with a third party (e.g., a coach, manager, or organization).

While coaching sessions are confidential, Kaizen Catalyst is not a HIPAA-covered entity and does not maintain protected health records.

3. Mental Health & Crisis Situations

Kaizen Catalyst does not provide clinical mental health services. If you are experiencing suicidal thoughts, severe emotional distress, or a mental health crisis, please seek immediate support from a licensed mental health professional or emergency services.

For immediate crisis support in the U.S., please contact:

  • 988 Suicide & Crisis Lifeline – Dial 988

  • Crisis Text Line – Text HOME to 741741

  • Emergency Assistance – Call 911

4. Scope of Practice & Professional Boundaries

  • Coaching is designed to help individuals develop mental performance skills, not to address trauma, mental illness, or clinical psychological concerns.

  • Kaizen Catalyst coaches are not licensed therapists, psychiatrists, or medical professionals.

  • If it is determined that therapy or medical intervention would better serve your needs, a referral to an appropriate provider may be recommended.

5. Participation & Expectations

To maximize the benefits of coaching, clients are expected to:

  • Engage actively in sessions and apply learned strategies.

  • Communicate openly about progress, challenges, or concerns.

  • Understand that results vary based on individual effort, commitment, and external factors.

6. Fees, Cancellations & Refunds

  • Coaching fees are due at the time of booking unless otherwise arranged.

  • Sessions may be rescheduled with at least 24-hour notice.

  • No refunds will be issued for missed sessions or late cancellations.

  • Package/session expiration policies may apply.

7. ADA Accommodations

Kaizen Catalyst is committed to providing an accessible and inclusive experience. If you require accommodations due to a disability, please inform us before your session to discuss available options.

8. Consent & Acknowledgment

Through the intake form above, I confirm that I have read, understood, and agree to the terms outlined in this Consent for Consultation Agreement. I acknowledge that coaching is not therapy, and I take full responsibility for my participation and well-being.