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Coach.
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Participation & Introduction
1
General Information
2
Goals for Participation
3
Past Stories
4
Enneagram
5
Participation Agreement
Name
First
Last
Date of Birth
Date Format: MM slash DD slash YYYY
Age
Gender
Male
Female
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
Email
Emergency Contact Name
First
Last
Relationship
Phone
Payment Instructions
(as arranged with Inzet management)
Goals for Participation
What do you most want to get out of YOUR Inzet Program?
List area(s) that you want to address as you participate in your Inzet to Purpose Program:
What would life look and feel like when you successfully complete your Inzet to Purpose Program?:
Past Stories
Recall the TEN most impactful stories from your past (both positive and negative) that contribute to who you are. Think about experiences that taught you something and helped you become who you are today. Think about the events and people that influenced you the most and recall specifics that impacted you. Once you have the TEN, narrow this list down to the FIVE that had the most impact and make a note about each that will enable you to share these stories in the first few sessions. These should just be vignettes. A fuller version will be discussed as part of the curriculum. Highlight the ONE that has had the MOST impact.
Story 1
Story 2
Story 3
Story 4
Story 5
Enneagram
The Enneagram is simply a map for self-discovery and personal growth. The diagram describes the 9 basic personality types based upon their unique ways of relating to the world. The Enneagram accurately and clearly describes why you think, feel and behave in particular ways based upon your core fears and core desires.
The power of the Enneagram is in its ability to harness and transform self-defeating behaviors into life-enhancing personal empowerment. The gift of the Enneagram is that through self-discovery, one can create and sustain meaningful and lasting relationships with self and others.
Complete the Enneagram profile and reply with your top 2 personality types:
https://assessment.yourenneagramcoach.com/
Top Score
Second Highest Score
PARTICIPATION AGREEMENT
Disclaimer – All Inzet services and communication, email or otherwise, are meant to help you identify the areas in your life and in your thinking that may be standing in your way. This agreement is for coaching (and possibly consulting), not therapy. While coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, coaching cannot deal with issues such as depression and anxiety, or other mental health conditions. For issues such as these, you must see a Physician or Licensed Mental Health Professional. The Inzet Team will not diagnose or treat any medical or psychological conditions. The Inzet Team members are not functioning as a licensed practitioners when offering our services. By signing this agreement, you are agreeing that you understand the difference in these two functions and you will get appropriate professional help for mental health issues if necessary. I understand that coaching is, at present, an unregulated industry and that The Inzet Team is not licensed by the State of Virginia or any other state. I understand and agree that I am fully responsible for my well-being during my Inzet sessions, and subsequently, including my choices and decisions. I understand that all comments and ideas offered by the Inzet Team are solely for the purpose of aiding me in achieving my defined goals. I have the ability to give my informed consent, and hereby give such consent to the Inzet Team to assist me in achieving such goals. I understand that to the extent our work together involves career or business, the Inzet Team is not promising outcomes included but not limited to increased clientele, profitability and or business success.
Confidentiality – All information obtained in the course of the professional service is confidential unless there is a compelling professional reason for its disclosure. The Inzet Team will disclose confidential information without a specific release if it is necessary to prevent foreseeable imminent harm to the participant or another. In all circumstances. The Inzet Team will be judicious in the amount of information that is disclosed. The Inzet Team may disclose confidential information without the consent of the client, only as mandated or permitted by law. When possible, the Inzet Team inform participants about the disclosure of confidential information and possible ramifications before the disclosure is made. The Inzet Team will only disclose confidential information to third parties with the appropriate written consent.
General – It is the Inzet Team’s intention to provide services that will assist you in reaching your goals. Based upon the information that you provide and the specifics of your situation. The Inzet Team and participants are partners in the Inzet Process. I hereby release, waive, acquit and forever discharge the Inzet Team, any agents, successors, assigns, personal representatives, executors, heirs and employees from every claim, suit action, demand or right to compensation for damages I may claim to have or that I may have arising out of acts or omissions by myself or by the Inzet Team as a result of the advice given, or otherwise resulting from the coaching and consulting relationship contemplated by this agreement. I further declare and represent that no promise, inducement or agreement not expressed in this agreement has been made to me to sign this agreement.
Agreement
*
by checking the box, this indicates that you have read this agreement for services carefully and understand its contents. Please ask the Inzet Team to address any questions or concerns that you have about this information before you submit.
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