Nutrition Consultation Coaching AGREEMENT

The following is a coaching agreement for the nutrition expertise and coaching of Culinary Nutritionist Nancy Campbell of Nancy Campbell, LLC.

Please review the terms of the agreement, and complete the form below to sign.


August 16, 2019


I am looking so forward to supporting you in achieving all of the juicy, exciting, and important things you really want for yourself.  I will be focusing my support on your nutrition and health needs and the role food can have in improving how you feel. 

Below I have outlined for you a few details for how we can make our coaching relationship flourish. I have also included a contract that scopes out the payment agreement, cancellation policy and the scope of my practice.

Fee:  You have selected the 3-month program, “Revamp & Realign” at Friends & Family rate of $734 (3 monthly payments of $249). As we discussed, over the course of 3 months you will receive:

·      45-minute complimentary intro call.

·      1.5 hour initial visit (virtual / phone).

·      1.5 hour first follow-up visit (virtual / phone).

·      (4) 60 min. follow-up visits every 2 -3 weeks (virtual / phone).

·      Weekly 15-minute as needed check-in calls to answer questions and support accountability.

·      Email access with my commitment of 48-hour response time.

·      Personally tailored recipes, meal planning, dietary support. 

Procedure:  For our first visit we will meet on Zoom on August 23, 2019 from 1:30 pm to 3 pm.  In order to see you for this first visit, I must have received your intake form fully completed by August 20, 2019.  Our first follow-up visit is scheduled for August 28, 2019 from 9:30 to 11 am.  You may request weekly 15-minute check-in calls on an as-needed basis. These can be prescheduled or requested on the fly by text or email. 

Subsequent sessions will be scheduled at the end of the preceding session.  You must use up your sessions no later than December 30, 2019.  All sessions can be done by phone, by video call, or in person.  

At each nutrition consultation visit, we will review your symptoms, your progress and challenges.  Depending on the progress of each visit, you will receive dietary recommendations, recipes, supplement recommendations and/or educational material in writing either at the end of the consultation or within 48 hours. 

Session Changes & Cancellations:  If you need to reschedule your session, please give me at least 48 hours notice or else you will forfeit the session time. If you have an emergency, we will work around it and make up the session.  Also, if you are running late to an appointment, please call or text 347-645-0181 and I will do the same for you.   

Extra Time/Sessions:  Should you feel the need to add an additional session within our 3-month program or after we have finished, we can schedule one-off sessions for $95.  If you need advice, have a problem or want to share a success with me, please don’t hesitate to email or text me.  

As you know, you have 24-hour access to me via email between sessions.  The only caveat to this agreement is when I am sick or I am out of the office on vacation. I will communicate with you if either situation occurs.  

If you want to connect directly over the phone or text, please reach out.  Included in your package are weekly 15-minute check-in calls.  I will do my best to return your call/text promptly or respond to set-up a time to speak.  I enjoy providing this extra level of service.  I just ask that we keep the extra calls brief.  If a topic or issue requires more time than our check-in call allows, we can continue the conversation via email, in our next scheduled session, or in an additionally scheduled session.

Open Communication: It is imperative that we both keep all communication lines open, clear and up front. I will continuously ask you to show me how to best coach you.  If I ever say or do anything that does not feel right, please address it.  In addition, I want your feedback and your guidance on what you need to be successful.  A healthy coaching relationship is a two way street.  The best way to meet your goals through our sessions will be to take personal responsibility and articulate what is working for you and what is not.  I also agree to offer the same courtesy to you.  

Coaching Proposal Agreed to by:


Above Agreed to by:

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Name - Client 1
Name - Client 2
Name - Client 2
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By providing your personal information above, checking the box below, and submitting this form, you agree to the terms of this agreement.