GRaCE Resource Center Recovery Coach Agreement

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Please review this document and acknowledge your willingness to accept help from a GRaCE Resource Center approved Recovery Coach. Any person who wishes to receive recovery coaching must sign this agreement first. Once you and your recovery coaching team have signed this agreement, you will receive a copy. You can show this agreement to people who want to know if you are working on your recovery, but we will not share copies of your signed agreement with anyone. Keeping this agreement is your responsibility.

Email *

Here is what you can expect from us.

1. We will support you and help you establish a plan for life in recovery.
2. We will help you connect with people who can help you succeed in recovery and we will explore services that you may want to consider using for support in attaining recovery.
3. We will keep our relationship with you confidential, but when needed share information with other recovery coaches within the GRaCE Resource Center.
4. We will not provide an evaluation of anyone’s recovery or report on anyone’s use of substances. We only acknowledge the period of time someone has participated in coaching, the regularity of their attendance, and acknowledge a person’s commitment to working on their personal recovery process.
5. We will not be able to provide transportation of any kind.
6. We are legally and ethically obligated to report a recovery coaching participant’s disclosure of personal involvement with child or elder abuse/neglect, threatened self-harm, or harm to others.
7. Recovery coaches in recovery centers do not provide formal clinical assessments, recommend a particular level of care, provide clinical treatment services, monitor abstinence, maintain clinical records, or dispense medications.

Here is what we expect from you:

1. Your recovery is your responsibility. Any decisions you make after considering your options in the recovery coaching process are your decisions and not the responsibility of your recovery coach.
2. Please keep your recovery coaching appointments and be on time. If you are unable to keep your scheduled appointment, please contact your coach as soon as possible.
3. You understand and agree that you will not see to hold your recovery coach, the GRaCE Resource Center Coordinator, GRaCE Resource Center, or Greater Recovery and Community Empowerment legally responsible for your decisions or actions.
4. You can contact the coordinator who signs below with any questions or concerns you have about your recovery coaching experience or if you feel you might benefit from having a different coach.

Together, we will explore what you can do to improve your life. We are here to help you think about ways your life can get better. We will support you in taking action and making your recovery successful.

Any other boundaries to be added to this agreement? *

Participants Last Name: *

Participants First Name: *

Participants Email:

Participants Phone Number:

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *

Yes

Required

Recovery Coach's Last Name: *

Recovery Coach's First Name: *

Recovery Coach's Email: *

Phone Number or other contact info for Recovery Coach: