Life Coaching Informed Consent & Confidentiality Agreement

Dr. David Simonsen, PhD (For Coaching and Consulting Services)

1. Purpose of Life Coaching

Life coaching is a collaborative, forward-focused process designed to help you clarify goals, identify obstacles, and create actionable strategies for growth and fulfillment. Coaching is not psychotherapy, counseling, or medical treatment and does not diagnose or treat mental health conditions. The purpose of this agreement is to define our professional relationship, establish clear expectations, and ensure confidentiality and ethical practice throughout our work together.

2. Nature of the Coaching Relationship

Coaching is a professional relationship that emphasizes self-awareness, decision-making, accountability, and action. You are responsible for your own choices, actions, and outcomes. Coaching may complement other professional support (such as therapy or medical care) but does not replace it.

3. Confidentiality Policy

Confidentiality is the cornerstone of this coaching relationship. All information shared with me, Dr. David Simonsen, remains confidential in perpetuity unless you give written permission for its release.

A. Client Information

Everything you share with me will remain confidential in perpetuity, unless you provide explicit written permission to share your identifying information (for example, in client success stories or testimonials). Although your personal information will not be shared, I may publicly discuss general, non-identifying anecdotes from my professional experience in online content. These are composite examples drawn from numerous sources and are never connected to any specific individual.

B. Business & Professional Privacy

All information concerning clients, former clients, guest speakers, assistants, personal matters, business matters, records, or intellectual property of Dr. David Simonsen obtained in a professional relationship is strictly confidential. This includes all correspondence, notes, and related materials. This confidentiality is essential to provide quality service and to maintain a trusting and secure professional relationship. No information may be released without proper authorization. This is a basic component of client care and business ethics.

4. Digital Security & Data Handling

I am committed to protecting your digital information securely to the best of my ability. However, I cannot guarantee complete protection from security breaches caused by external, unknown parties outside the scope of my technical expertise.

Client & Team Data Practices

Clients and any contracted team members (none currently) are expected to delete identifying correspondence after ending the professional relationship, except for materials that have been approved for ongoing safekeeping or sharing. Names or identifiers must be removed unless explicit written permission has been granted. General or statistical information not tied to specific individuals is not classified as confidential. This policy protects both you and me.

5. Consent & Use of Information

Consent will always be requested before sharing testimonials or identifying details publicly. I may use anonymized anecdotes or generalized examples from our work in coaching, teaching, or marketing materials, ensuring no identifying information is disclosed.

6. Professional Boundaries and Responsibilities

My Responsibilities: To provide professional, respectful, and supportive coaching services; to protect your confidentiality, privacy, and digital information; to maintain accurate, secure records and appropriate boundaries at all times.

Your Responsibilities: To participate actively and honestly in the coaching process; to uphold mutual respect and confidentiality; to make your own informed decisions and take responsibility for outcomes.

7. Certification of Understanding

I have read and understand Dr. David Simonsen’s confidentiality policy and this informed consent document. I agree to uphold and respect its terms. I understand that a violation of this policy may result in termination of the coaching relationship. I also understand that any malicious threats, defamation, or accusations directed at Dr. Simonsen may void confidentiality protections in defense of professional integrity.

8. Acknowledgment & Agreement

By signing—or by purchasing or participating in coaching services—you acknowledge that you have read and understand this agreement in full, agree to abide by it completely, and are legally capable of entering into this agreement.