This is an important disclosure statement about coaching provided by Integrated Man, LLC.

In the following, all references to Integrated Man, LLC, include, by reference, John Sambrook, Manager. All uses of “me” or “I” refer to John Sambrook, Manager.

Please read, sign and return this disclosure statement, if you agree to be bound by it.

DISCLOSURE STATEMENT

  1. Coaching by Integrated Man, LLC, is not counseling or therapy of any kind. It is education and discussion between laymen and no professional services of any kind are rendered.
  2. No one at Integrated Man, LLC, is qualified to tell you if you would benefit from professional mental health counseling.
  3. If you think you might benefit from mental health counseling, please let me know. I will always be entirely supportive of any wish on your part to seek whatever help you may wish to pursue.
  4. There is no diagnosis listed in the “Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for the NICE GUY SYNDROME (NGS). The Nice Guy Syndrome is not a mental illness, but a set of beliefs and behaviors that contribute to the individual self-perceptions.
  5. Coaching from Integrated Man, LLC, is not covered by insurance. Payment must be made before coaching services will be provided.
  6. Coaching from Integrated Man, LLC, draws on materials from different domains. Many of these materials come from the work done by Dr. Robert Glover and is focused on helping men to understand and work their way out of Nice Guy Syndrome.
  7. When you work with Integrated Man, LLC, beyond any initial consultation meetings, you are entering into a financial arrangement with Integrated Man, LLC. All fees must be paid in advance.
  8. Neither results nor success are guaranteed. Only you, the client, have the power to create these – I am here to hold space for you in your work to more fully develop yourself.
  9. There are no refunds for unused or missed sessions.
  10. You can end the coaching relationship at any time and for any reason, or for no reason.
  11. Integrated Man, LLC, will never willingly share your personal information with others without your written permission or unless compelled by law enforcement.
  12. When you work with Integrated Man, LLC, you agree to keep confidential personal information that is disclosed to you by me or by any other men with whom you may be in group.
  13. Owing to the nature of the internet and individuals who engage in computer intrusions, there can be no guarantee of perfect security for any information you disclose. Integrated Man, LLC, agrees to make a sincere best effort to maintain confidentiality for all clients.
  14. I see my role as providing you with all that I reasonably can to help you achieve your goals for your life. To do this, I will sometimes raise issues that will be difficult for you, highly uncomfortable, and that you may not believe you are ready for. I will always work to engage you in a kind and compassionate manner.
  15. I will be well-rested and prepared ahead of our sessions and dedicated to serving you to the best of my abilities.
  16. In any context, at any time, if you are feeling overwhelmed, upset, or you simply want to stop the discussion instantly, please just say “I need a break right now.” When you say this, any discussion we are having is over and we will move on to the next man in group (if we are in group) or I will pause and give you as much time as you like. We can end the session if you wish to do so.
  17. At Integrated Man, LLC, there is no shame or blame – ever – for taking care of yourself and for asking for what you need or want.

Received and accepted by: _________________________________

Date Accepted: _________________________