Landing Space, Companionship Sessions – Client Information Form (Fully or Partially Funded)

Thank you so much for your interest in joining me in this space. Please fill in the form below.

Before we do, please fill in the below form and read through the client agreement below, and click the consent button at the end. You will then be sent the document via Hello Sign for a digital signature, where I will sign it too (you do not need to sign up for an account to use this service, or scan in a signature – you can do this digitally). If there are any changes needed I will highlight them to you prior to sending the form to sign.

I will then be in contact with you via the email provided where I will send you a link to schedule the sessions.

I am truly honoured you are here and I am looking forward to connecting with you more.

If you have any questions, please don’t hesitate to contact me: sarah@traumaandco.com

CLIENT INFORMATION FORM

COMPANIONSHIP SESSIONS CLIENT AGREEMENT

1. You are engaging with me and Trauma & Co. to provide Landing Space, Companionship Sessions on the terms of this agreement.

2. This agreement will commence on the date you provided above and will continue unless and until terminated by either of us (see section 7)

3. SESSIONS, CANCELLATIONS & COMMUNICATION

3.1 All sessions will take place digitally via Zoom (you will need to download Zoom to your device prior to our first meeting) and will last for up to one hour.

3.2 From time to time, there may be scheduling conflicts for either of us. Where possible we will reschedule as needed prior to the session. Any sessions cancelled due to scheduling conflicts, can be rescheduled. Either of us may cancel or reschedule a session by notice via email to the other no less than 24 hours prior to the start of the meeting.

3.3 It is understood that sometimes sudden events, such as emergencies, illnesses or internet shortages, happen that may make it necessary for either of us to cancel our appointments last minute or fail to attend and are unable to provide notification.

In the event of emergencies, illness or internet shortages, we will give each other as much notice as possible for cancelling or rearranging sessions.

In the unlikely event that I miss an appointment without notice, you will be refunded for the time (if you have paid partially) or offered an alternative time. In the event that you miss an appointment without notice it is at my discretion if a fee will be charged (if you are paying partially) or if the funding is deemed used.  

In general however, if you fail to give less than 24 hours notice of your intention to cancel or reschedule an agreed appointment, or if there is a repeat pattern of cancellations/non-attendance, I reserve the right to charge for that session (if you are paying partially) or deem the funding used.

3.4 If for any reason you are late for a session, I will see you for the duration of the remainder but may be unable to continue beyond the allotted time.

4. RESULTS

4.1 These sessions are not therapy or coaching and as such there are no specific ‘results’ promised or to be expected. You are entering this space to be met in your reality and are offered companionship in this reality.

4.2 Any resources given (if you ask for resources) are received by you with full responsibility for taking care of your needs. We can discuss this throughout our sessions if this is the type of support you want.

5. FEES (If you are partially paying, or if you have a change in finances and later agree to pay for sessions. please note 5.4 is applicable to all clients)

5.1 I will invoice you in advance at the rate agreed, usually monthly (in exceptional circumstances other payment plans may be offered, i.e. weekly payments).

5.2 Automatic payments will be made via a link I will provide you with via PayPal (where possible) on a monthly basis (or as otherwise agreed to verbally or via email). Or I will provide you with a PayPal invoice that is due to be paid prior to the sessions starting, at the frequency agreed to above.

5.3 I will pay processing fees in PayPal for all clients who pay on time. If sessions are terminated and a partial refund is warranted, I reserve the right to recover any fees paid on all payments. I will refund any payments within 30 days after the written notification.

5.4 You are responsible for all expenses incurred by you in connection with your participation in the sessions with me (e.g. internet fees).

5.5 If you fail to pay me by the due date, I may suspend all services until payment has been made in full.

6. CONFIDENTIAL INFORMATION

6.1 I agree not to (except in the proper course of my duties) use or disclose to any third party any confidential information. Confidentiality does not apply where it would mean that I might break the law or if I consider there is a risk you may harm yourself or others. In such exceptional circumstances, where there is concern for your wellbeing or that of others, it may be necessary to seek help outside of our relationship. In such an event where I am considering breaching confidentiality, you will normally be consulted first.

In the case of a disclosure concerning acts such as terrorism, vulnerable adult or child protection issues or human trafficking, confidentiality may be breached and such disclosures may be passed onto the relevant authority.

6.2 You agree that I may disclose any issues or feelings which arise out of our sessions together with my supervisor and therapist, but I agree only to disclose such issues on a general basis and without disclosing your name or specifics.

6.3 You may disclose to third parties such information about our sessions as you wish. Where I am made aware that you have disclosed our sessions together, I may confirm that I know you but I would not divulge any details of your Companionship Sessions.

6.4 While you are not bound to confidentiality about our sessions together, as is good practice, we both agree to asking for consent before sharing any sensitive or personal information about the other.

7. TERMINATION OF CONTRACT

7.1 We both agree to give 1 month notice for termination of sessions, including any extensions beyond the initial 3 month period.

We both agree to keep each other informed should there be any foreseeable changes coming up which may impact our future sessions.

7.2 I will not suddenly or without warning terminate our contract, except in exceptional circumstances, which would become clear in the course of our sessions together. This would be fully discussed at that time. Please note threats or acts of violence will invalidate this agreement.

8. HOLIDAYS

8.1 Where regular sessions are agreed upon, you will be notified of any holidays to be taken by myself with at least 1 month notice (or more where possible). I will try to give you as much notice as possible of any cancellations to regular sessions, and will either offer an alternative time for the sessions or I will not charge you for that time.

9.3 If you plan to take a holiday during our agreement time (or if we extend the agreement) you agree to giving me at least 1 month notice for this (or more where possible).

9. ADDITIONAL NOTES

9.1 As we may be connected online and may have mutual contacts in our personal or working lives, the boundaries of our relationship (such as contact outside of our sessions and communication about our working relationship) can be agreed upon between us during our work together. As good practice, we ask for what we need and try to honour the boundaries and consent of the other at all times.

9.2 We agree to enter into our sessions together and communication with each other from a place of respect and compassion.