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2021 Policies & Procedures for Private Sessions

Please fill out, read, and submit at least 48 hours before your appointment.

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2021 Private Session Policies & Procedures

FORM SUBMISSION GUIDELINES

 

This form must be submitted each year by the following:

Clients 18 and older

A Parent/Guardian of a Minor-aged Client

The Party Responsible for Payment

 

There are several variables here.  Please make sure all involved parties submit this form.

 

All Clients 18 and older who are also the Party Responsible for Payment submit this form.

 

**If the Client and the Party Responsible are NOT the same people, then the Parent/Guardian (Responsible Party) will first need to book and complete an Introductory Session and one Regular Session as a Client before I will begin working with the dependent child.  Parents, in this case, you will fill out this form first with yourself as the Client.  Later, you will fill out this Policies Form as a Parent/Guardian for your child after you have completed your sessions.**

 

A Parent/Guardian submits the form for a minor - aged Client only after the Parent/Guardian has completed The Introductory Session and a Regular Session.  If the Parent/Guardian is NOT the Party Responsible for Payment, then a separate form must be submitted by both parties. 

 

Parents/Guardians submit only one form for a Minor-aged child if they are also the Party Responsible for Payment.

 

 

 

Personal Information

Your Information is never shared or sold!

 

Correct contact information is vital.  It is used here primarily for communicating about appointments:  questions, scheduling, appointment confirmations, rescheduling, and reminders.  Please include the client's contact information - 14 years old and older - to help make sure communication is open, up to date, and helping everyone arrive at sessions on time.

 

STEPS TO COMPLETE THE FORM

 

The intake system has some limitations, and therefore, you will see fields that need a duplicate answer.  In these cases, please write out the correct answer again, instead of "same as above" type answers.

Some fields may not apply to you, but you will need to read and answer those, too (write N/A in those.)

 

Please fill out all fields correctly to complete the form.

The Private Session Policies & Procedures Form will not register as complete unless you check all the boxes, signifying you have read and agree to all Policies & Procedures.

 

Thank you for your patience!

 

 

Question 3 of 35

Your Email:

Question 4 of 35

Your Name:

Question 5 of 35

Is the Client a Minor-aged Child?  ("Yes" or "No")

Question 6 of 35

Parent/Guardian Name if the Client is a minor:  (N/A if it doesn't apply)

Question 7 of 35

Parent/Guardian Email if the Client is a minor:  (N/A if it doesn't apply)

Question 8 of 35

Parent/Guardian Mobile Phone if the Client is a minor: (N/A if it doesn't apply)

Question 9 of 35

Client's Name:

Question 10 of 35

Client's Age:

Question 11 of 35

Client's Date of Birth (dd/mm/yyyy):

Question 12 of 35

Client's email:  (put N/A if the client is 13 or younger)

Question 13 of 35

Client's Mobile Phone:  (put N/A if the client is 13 or younger)

Question 14 of 35

Name(s) of Party Responsible for Payment:

Question 15 of 35

Email of Party Responsible for Payment (please list the email attached to PayPal payment.) :

Question 16 of 35

Mobile Phone of Party Responsible for Payment:

2021 Private Session Policies & Procedures

For Peggy Nazer Coaching

Question 18 of 35

Steps After Booking:

 

  • Complete and submit Introductory Session Forms 48 hours before appointment time (sent via email upon booking).
    • You click on the links provided- just as you did to get to this form.
  • Complete and submit Regular Session Form 24 hours before appointment time (sent via email upon booking).
  • Submit PayPal request 48 hours before appointment time (sent via separate email within 24 hours of booking).  NOTE:  Because the billing email is sent later, choose to pay at the time of booking if you are scheduling 3 or fewer days in advance to avoid late payment.
  • Contact me at appointment time:  801.772.0176

(Select all that apply)
A

I understand the steps to complete after booking

B

I understand I need to submit Introductory Session Forms 48 hours before my appointment

C

I understand I need to submit payment 48 hours before my appointment

Question 19 of 35

Deadline Policy:

 

To make the most of your session; many housekeeping items have deadlines that help me streamline the booking, intake forms, and payment processes.

 

A 48-hour deadline to submit Introductory Session Forms.

 

A 48-hour deadline to submit Cancellations, Reschedules, and Payment.

 

A 24-hour deadline to submit Regular Session Form.

 

 

(Select all that apply)
A

I have read, understand, and agree to the 48 Hour Deadline for Introductory Session Forms Submissions

B

I have read, understand, and agree to the 48 Hour Deadline for Cancellations, Reschedulings, and Payment

C

I understand I have a 24 Hour Deadline for my Regular Session Check-In

Question 20 of 35

Intake Forms Required:

 

  Before the Introductory Coaching Session:

 

       Peggy Nazer Coaching Policies & Procedures Form

       Intake Forms - Release Form & Hold Harmless Form

       New Client Questionnaire

  

Before All Other Sessions:

 

        Pre-appointment Check In

 

(Select all that apply)
A

I understand which Intake Forms are required before the Introductory Coaching Session

B

I understand which Intake Forms are required before all other sessions

Question 21 of 35

Intake Form Submission According to Age:

 

Having the right forms and feedback from all interested parties in advance increases the quality of your sessions.  Failure to have all forms submitted by all the correct parties 48 hours before the Introductory Session time can result in more time spent on paperwork instead of coaching.  Extra time will not be added to the session to make up for the time used on paperwork.

 

Here are the requirements on who submits which forms:

 

  • Clients 18 years and older, and are the Party Responsible for Payment, must submit all forms.
  • Clients 18 years and older must submit all forms, even if they are NOT the Party Responsible for Payment.
    • If the client is NOT the Party Responsible for Payment but is still considered a dependent, then the Parent/Guardian/Party Responsible will also submit all forms.
  • Parent/Guardian/Party Responsible for Payment must submit all intake forms for children considered a dependent (single child age 24 or younger, or older child with special needs)
    • Submit background information and observations about the child for each session.
    • This includes the "New Client Questionnaire" and "Pre-Appointment Check-In."
  • Parent/Guardian/Party Responsible for Payment must submit all intake forms for adult children whose service they are paying for.  (ex. married child, 25 or older.)
    • This includes the "New Client Questionnaire" but DOES NOT include the "Pre-Appointment Check-In."
      • Submit background information and observation about the child for Introductory Session only.
  • Clients 14 years and older need to submit the "New Client Questionnaire" and "Pre-Appointment check-in" forms.

(Select all that apply)
A

I understand the submission of forms by age procedure.

B

I understand that if I am a parent of a dependent child, I submit the Questionnaire and Check-Ins in addition to my child's submissions

C

I understand that dependent children 14 and older submit a Questionnaire and Check-Ins

D

I understand that if I am the Party Responsible for Payment for services for my married child or my child 25 or older, then I submit all forms including the Questionnaire, but do not submit Check-Ins.

Question 22 of 35

**Submitting all forms by all involved parties for Introductory Sessions  48 hours before the appointment time is required so that I can review and prepare for the session, otherwise, time is spent on paperwork and not coaching.  Regular Sessions have a 24-hour deadline for Check-Ins.  Please complete forms by the deadline, so they don't take priority over working with the client.  Extra time will not be added to the session to make up for the time used on paperwork.

(Select all that apply)
A

I understand the 48-hour submission deadline for all Introductory Session Forms

B

I understand I need to submit Regular Session Check-In Forms 24 hours before my appointment

Question 23 of 35

Billing Procedure:

 

After booking your appointment, you will receive an email with a PayPal invoice along with the payment deadline.

 

NOTE:  This email is sent within 24 hours of booking.  It is not sent immediately after booking.  Remember, all payments are due at least 48 hours before your session time, so if you are booking a session 2-3 days in advance, select the "Pay now" option so that payment is received before the 48-hour deadline.  The invoice will come separate from your appointment confirmation.

    • Please complete before your 48-hour payment deadline.
    • To keep my bookkeeping straight, please pay from this specific email request rather than creating your own.
    • Any additional fees will also come through PayPal.

 

(Select all that apply)
A

I understand that my session(s) bill will come via separate email with a PayPal request

B

I understand that my payment is due at least 48 hours before my appointment time or before 48 hours of the first appointment in a multiple session package

C

I understand if I schedule an appointment 2-3 days in advance, to pay on time, I need to pay at the time of booking rather than wait for a PayPal invoice

Question 24 of 35

Coaching Packages:

 

"Mini" packages are available for those who would like private sessions on an ongoing basis and like the convenience of bundling payment.  These packages are designed to be used within a month.  No refunds are available, so please select these options only if you feel committed to completing a private session package within a month.



(Select all that apply)
A

I understand that multiple session packages are to be completed within a month and are not refundable

Question 25 of 35

Payment Policy:

 

  • The deadline for payment is 48 hours before your appointment time.
  • Failure to make payment by the deadline will incur a $20 late payment fee and result in cancellation without notice.
  • Payment for services is the final step in confirming & reserving your appointment time.
    • If you miss your payment deadline, and another client is put into your slot, your appointment will be canceled without prior notice. You will receive an email notification that your appointment time has been canceled.
    • Please pay each fee from their specific email requests.
    • Both fees will need to be paid as soon as possible to avoid being eligible for cancellation and before the session can begin.
    • If a client in distress or has an emergency contacts me, I reserve the right to book them into a slot past its 48-hour payment reservation deadline.
    • If you miss your 48-hour payment deadline; there will be a $20 late payment fee (also sent via email) in addition to the session fee.
    • No extra time will be added to the session to handle payment issues that could have been addressed earlier.



(Select all that apply)
A

I understand that payment for service is the final step in reserving my appointment time

B

I understand and agree to a $20 late payment fee if I do not send payment 48 hours before the appointment time or before the first session in a multiple session package

C

I understand and agree to the condition that my appointment may be canceled and given to another if I do not pay by the 48-hour deadline

D

I understand and agree to all fees being paid before the session can begin

Question 26 of 35

Appointment Procedure:

 

Call Time:  Session appointments are usually done over the phone; however, clients may choose an online appointment via skype if they prefer.  Phone calls can be less distracting.  Skype calls can sometimes be helpful when working with children.

  • There is a place to make this choice on the Questionnaire and the Check-Ins.
    • Clients 14 & older and their parent(s) are both submitting forms, so, please make sure both of you make the same selection on your individual forms.
  • Clients contact me at the scheduled appointment time.
  • My phone is a landline and does not accept texts at this time.  Phone #: 801.772.0176
  • Skype calls require a minimum notice of 24 hours.  Find me at peggy.nazer

(Select all that apply)
A

I understand and agree with how appointment time is started

B

I understand that Peggy's phone number does NOT accept texts at this time

C

I understand that if I desire a Skype call, I must give 24 hours notice; otherwise, the session will default to a phone call

Question 27 of 35

What to Expect:

 

Private sessions are a combination of coaching, training, and Energy Psychology(EP).  EP is a collection of mind-body approaches for understanding and improving human functioning.  EP focuses on the relationship between thoughts, emotions, sensations, behaviors, and known bioenergy systems (such as meridians and the biofield). I want you to feel comfortable and introduced to what to expect before our Introductory Session. If you haven't done so already, read the answers on my FAQ's page, so you have a working knowledge of what I do, how I do it, the materials you need on hand, and the options available to you. That way, we get the most out of our time together. I will answer any additional questions you have during our Introductory Session. Click to go to FAQ's page: https://www.peggynazer.com/faq-s *



(Select all that apply)
A

I have read FAQ's page and understand appointment procedures

B

I understand I need to have printer paper and crayons on hand before the start of all sessions

Question 28 of 35

Appointments for Dependent Children:

 

I do a combination of coaching and energy psychology in most sessions.

 

  • I often use a version of color therapy with clients of all ages, but particularly with children, so please have printer paper and crayons at hand before every session.
  • At least one parent is required to have an Introductory Session and one regular private session with me before I begin working with a minor-aged child or a child who is not responsible for payment.  Children progress better and faster when parents know first hand what sessions are like.
  • After booking an Introductory Session for themselves, Parents must fill out a New Client Questionnaire about themselves as the Client.  Submit the Questionnaire 48 hours before the Introductory Session.  Parents will schedule an Introductory Session for themselves and do at least one regular session before I begin work with the child.  We'll determine the best course of action for the child at that time.
  • Parents need to be available &/or present during sessions involving all minor children, and children not responsible for payment unless other arrangements are agreed upon by all parties.  Plan on being present for your child's first session and let them know you will be there but may not stay for the whole time if they don't want you there.
  • It is not unusual for children, including older teenagers and young adults, to want their parent(s) present for the entire first appointment.
  • Many children prefer their parent(s) to be present at all appointments.
  • There is a question on the Check-In for both the parent and the child 14 years of age and older.  This will help us to determine how the Session will proceed.
    • This is something for you to discuss together before the session, so you both are putting the same answer on your respective Check-Ins.

 

 **NOTE:  The Party responsible for payment is held responsible for all fees incurred.  To keep infractions of policy to a minimum and avoid additional fees, it is recommended that you go over these policies with your child and keep good communication with them about their schedules, the importance of keeping appointments, giving ample notice if needing to reschedule, submitting intake forms, etc.

 

(Select all that apply)
A

I will have paper and crayons already available before each session begins

B

I understand that if I would like Peggy to work with my minor-aged child or with an older child for whom I am paying, I must begin by doing the Introductory Session and the session thereafter for myself. When my child begins sessions will be determined after my first regular session.

C

I understand that I am expected to be present for my minor child's First Session and that my presence and/or availability will be determined for future appointments during that time

D

I understand that my child, regardless of age, may prefer that I be present for all their appointments

E

I understand and agree that as the party responsible for payment, I am held responsible for the child's violation of any procedure or policy and the payment of the associated fees and fines.

Question 29 of 35

Additional Appointments may be needed for parent(s):

 

Parents are leaders.  As long as a child is living in your home or subject to your authority, they follow your lead.  Sometimes for a child to move forward, a parent needs to engage in more than just the first two appointments.  I love working with children!  Be prepared for the possibility that you may have more appointments in your future to help your child shift.  Children subject to their parents cannot go past them until they've left home.  Parents do not always have to do more appointments after the initial two, but I find it a good practice to clarify it as a possibility.



(Select all that apply)
A

I understand that if I have a child doing appointments, I may need to do more appointments myself after the initial two sessions

B

I agree to complete additional sessions for myself if Peggy recommends them to be necessary.

Question 30 of 35

Rescheduling and Cancelling Procedure:

 

  • Up to 48 hours before your appointment time, you have the ability to cancel and reschedule your appointment yourself via the confirmation email you received at the time of booking.
  • This convenience is available 24/7.
  • It is the preferred method for schedule changes and will be the quickest way to adjust your schedule.
  • This saves us both time.
    • You don't have to play email/phone tag with me.
    • You can make sure you get it completed before the 48-hour deadline.

 

**Rescheduling and Cancellation requests after the 48-hour deadline must be sent to email:  [email protected]

 

(Select all that apply)
A

I understand where to go to cancel or reschedule my appointment

B

I understand that after the 48-hour deadline, this option is not available

C

I understand that after the 48-hour deadline, I send a scheduling request email to: [email protected]

Question 31 of 35

Rescheduling Policy:

 

Every effort is made to help clients juggle unexpected changes in their schedules.  Please be very conscious of the fact that the nature of these appointments can sometimes challenge you to keep your appointment time.  Often the times you want to reschedule are the very times you need to continue forward and remove the block in your way.

 

  • You may cancel, reschedule and send a message to me via the confirmation email you received after booking your appointment.
  • You may reschedule yourself anytime before the 48-hour deadline.
  • If you reschedule before the 48-hour deadline, then full payment will be credited to your next scheduled appointment.
  • In the event of an emergency after the 48-hour deadline, the system will not let you make changes.  Reschedule by sending an email to [email protected]
  • Multiple needs to reschedule after the 48-hour deadline will incur a $75 rescheduling fee.  The fee will be sent via email and is due before the rescheduled appointment time.



(Select all that apply)
A

I understand I may reschedule before the 48-hour deadline with full payment moved to my new appointment time

B

I understand that after the 48-hour deadline, I send a scheduling request email to [email protected]

C

I understand that requests after the 48-hour deadline should be sporadic, and if late requests become common, a $75 rescheduling fee will be charged

Question 32 of 35

Cancellation Policy:

 

Sometimes people are tempted to cancel, instead of rescheduling, an appointment.  Please be very conscious of the fact that the nature of these appointments can sometimes challenge you to keep your appointment time.  Often the times you want to cancel are the very times you need to continue forward and remove the block in your way.

 

  • There is a 48-hour cancellation, rescheduling, and payment policy to allow time to fill and reserve your slot.
  • Payment for services is part of reserving your appointment.
  • The deadline for payment is 48 hours before your appointment time.
  • Failure to make payment by the deadline can result in cancellation without notice.

 

The following are situations regarding Cancellation, WITHOUT rescheduling.

 

  • If you cancel before the 48-hour deadline without rescheduling, then a full refund will be issued minus a $3 booking fee.
  • If you miss your appointment or cancel with less than 48 hours notice, no refund will be issued.
  • If you miss your appointment or cancel with less than 48 hours' notice and have not made the payment, you are still responsible for paying your session fee and a $40 cancellation fee.
  • If you miss your appointment, you have not made the payment, and you did not contact me to cancel; you are still responsible for paying your session fee and a $75 no show fee.
  • Fees need to be paid before you book another appointment.
  • For cancellations after the 48-hour deadline, send an email to [email protected].

 

**Fees need to be paid before you book another appointment.  If you cancel, resetting your account may be necessary.  Before booking a new appointment using the online calendar, please send a new booking request to [email protected].

 

(Select all that apply)
A

I have read, understand, and agree to the Cancellation Policy and its associated fees

B

I understand that cancellations after the 48-hour deadline require an email sent to [email protected]

C

I understand that if I cancel an appointment and wish to book another session later, I need to send a new booking request to [email protected]

Question 33 of 35

Completed Policies & Procedures Forms are required from Clients 18 years and older, Parents of Minor Clients, AND the Party Responsible for Payment of Services.  Submit separate forms where necessary so that all forms are received from all required parties.

A

I understand that this Policies & Procedures Form must be submitted by clients 18 years and older, by parents of minor clients, AND by the party responsible for payment. Failure to fill out all fields and submit this form by all parties involved 48 hours before the session will prioritize completing and submitting all necessary forms. No extra time will be allotted to the session to make up for time spent on forms.

Question 34 of 35

You certify that you have read, understand, and agree to all the policies and procedures for Peggy Nazer Coaching.  Your submission of this form serves as your electronic signature.

 

(Select all that apply)
A

I certify I have read, understand, and agree to the policies and procedures for Peggy Nazer Coaching. I understand that my submitting this form serves as my electronic signature.

Question 35 of 35

Type Your Name As It Would Appear on a Signed Document:

Confirm and Submit