Couples Coaching Agreement

Before we begin, I ask that each partner take a few minutes to read and acknowledge the agreement below.

This helps make sure we're all clear on what couples coaching is, what you can expect from me, and the boundaries that allow us to create an open, supportive and productive space together.

Please complete this agreement individually. Each partner must submit their own form before our first session.

Scope of Coaching

Couples coaching with Madison Pinder of La Vii Wellness is intended to provide a supportive space for couples to better understand their relationship, improve communication and connection, explore patterns and challenges, and gain greater clarity around how they would like to move forward together.

I understand that Madison Pinder is acting as a Relationship Wellness Coach and is not acting as a psychologist, psychotherapist, psychiatrist, physician, licensed mental health counsellor or other regulated healthcare professional.

Coaching is not intended to diagnose, treat or cure any mental health or medical condition and is not a substitute for psychotherapy, counselling, medical care, substance-use treatment or other professional healthcare.

If concerns arise that fall outside the appropriate scope of coaching, Madison may recommend that one or both partners seek support from an appropriately qualified professional.

Personal Responsibility

I understand that I am responsible for my own well-being, choices, actions and decisions both during and outside of coaching sessions.

The perspectives, questions, exercises and suggestions offered during coaching are intended to support reflection, awareness and growth. I remain responsible for deciding what actions, if any, I choose to take as a result.

I understand that coaching outcomes cannot be guaranteed. Progress depends on many factors, including each partner's participation, honesty, willingness and circumstances.

Couples Coaching

I understand that Madison's role is not to determine who is right or wrong, take sides, assign blame or advocate for one partner over the other.

The coaching relationship is intended to support the relationship and the individuals within it by creating space for honest communication, greater understanding and clarity.

Both partners agree to participate voluntarily and to communicate as openly and respectfully as reasonably possible.

I understand that couples coaching does not guarantee reconciliation, relationship improvement or that the relationship will continue. In some circumstances, greater clarity may lead a couple to make decisions about their relationship that are different from what they initially expected.

Confidentiality Between Partners

Information shared during coaching sessions will be treated as private and confidential except where disclosure is required or permitted by law.

Because this is couples coaching, I understand that confidentiality operates differently than it would within an individual coaching relationship.

Information shared during a joint session is considered part of the couples coaching process and should not be expected to remain confidential from the other partner.

If either partner communicates privately with Madison outside of a joint session about something materially relevant to the relationship or coaching process, Madison cannot guarantee that the information will be kept secret from the other partner.

Madison will not intentionally create or maintain secret alliances with either partner. If significant information is disclosed privately, Madison may encourage the individual to bring that information into the joint coaching conversation and may determine that couples coaching cannot appropriately continue while material information is intentionally being withheld.

Whenever possible, expectations around how information will be handled will be discussed openly with both partners.

Limits of Confidentiality

I understand that confidentiality may be limited where disclosure is required by law, court order, or where Madison reasonably believes there is an immediate and serious safety concern.

If information arises involving abuse, neglect, threats of harm, or another matter that may create a legal obligation to disclose information, Madison may take steps reasonably necessary or legally required.

Safety & Appropriateness of Coaching

Couples coaching is not intended to provide crisis intervention or emergency support.

If Madison believes that circumstances within the relationship fall outside the appropriate or safe scope of coaching — including circumstances involving significant mental health concerns, abuse, coercion, violence or immediate safety concerns — she may pause or discontinue couples coaching and recommend appropriate professional support.

Either partner may also choose to discontinue coaching at any time.

Technology & Online Sessions

I understand that coaching may take place using email, telephone, Zoom or other electronic communication.

While reasonable measures are taken to protect privacy, no electronic communication system can be guaranteed to be completely secure. I acknowledge and accept the inherent privacy risks associated with the use of these technologies.

Session Fees & Scheduling

The fee for a 90-minute couples coaching session is $400 CAD, payable in full in advance to secure the appointment.

Payment may be made by credit card or e-transfer.

Sessions may be rescheduled with a minimum of 24 hours' notice.

Sessions cancelled or rescheduled with less than 24 hours' notice, as well as missed appointments, are considered forfeited and the session fee will not be refunded or transferred.

If either or both partners arrive late, the session will still conclude at the originally scheduled time.