Sport Psychology Services Agreement
Welcome to my practice. This document contains important information about my professional services and business policies. Please read it carefully and email me any questions you might have ([email protected]). When you sign this document, it will represent an agreement between us.
Professional qualifications: All the mental training programs were developed by a Mental Performance Consultant. Master’s degree in Sports and Performance Psychology (MA). American Board of Sport Psychology; Certified Sport Performance Consultant (ABSP-BC). Biofeedback Certification International Alliance; Board Certified in Biofeedback (BCB).
Type of Services: The purpose of in-person or online sessions is to teach athletes (clients) specific skills for application in exercise, sport, and other contexts. Such instruction or interventions could focus on relaxation, concentration, imagery, positive self-talk, centering, goal setting, mind and body self-regulation, etc. The goal within performance settings is to help athletes (clients) understand, measure, and strive to improve elements of their performance. This does not include diagnosis or treatment of pathology such as depression, eating disorders, anxiety disorders, and other issues that would meet the diagnostic criteria of a mental disorder. It does not include counseling services for life circumstances that can affect performance, such as parental relationship distress, separation or divorce, and loss of a loved one.
Access to Service: Sport Psychology services or Biofeedback Training are provided during normal business hours from 9:00 am to 5:00 pm. You can call or email during this time to schedule an appointment through video conferencing or meeting in person at the office. The online portion of your mental training program is available 24/7 for six months after the purchase.
Confidentiality: Any records made of you will be kept for 4 years and then destroyed. All information is kept confidential, stored safely each day, and does not leave the office building. However, you should be aware that we may break confidentiality under the following circumstances:
- If you are under 18 years of age, parents or guardians have access to the records and may authorize its release to third parties.
- If you are assessed to be in imminent danger of hurting yourself or someone else (it includes minors using or contemplating to use performance enhancement drugs)
- If you say that children, elderly, or handicapped people are being abused (it includes abusive behavior from parents and/or coaches).
- If you report sexual misconduct of a therapist, teacher, coach, or others close to you.
- In a legal case, when your records get subpoenaed by the law.
Upon your request, I can release information to other professionals involved in your training (coaches, sports managers, psychotherapists). However, you decide what type of information to be released.
Service Fees: The fee changes according to the type of services that were agreed. I charge a fee of $175 (one hundred seventy-five dollars per session). I work for periods of 50 minutes (one session) or 30 minutes (half session). The initial evaluation cost $185 (one hundred and eighty-five dollars). You can cancel a session if you provide 24-hour (1 day) advance notice. You will be expected to pay for each session at the time it is held. The self-paced mental training program costs $445 (four hundred forty-five dollars) and has three 30-minute sessions to be scheduled in addition to the online platform.
Intellectual Property: Mental Performance Consultant and client agree that all the interventions, trade secrets, confidential and/or proprietary information, and work-product conceived, created, and developed by the sport psychology professional are the sole and exclusive property of the athlete’s treasure business. Athletes can use logs and the information received for personal development, but it cannot be copied, reproduced, or used to coach other athletes. There shall be no transfer of intellectual property through this Agreement. All copyrights, patents, trademarks, or other intellectual property shall stay with the original party owner.
Your signature (checking the box) above indicates that you have read the information in this document and agree to abide by its terms during our professional relationship.