Caregiver Coaching Client Service Agreement

Please read carefully. By agreeing to receive coaching from Twenty-Once Senses Inc. NFP (4923 W. Balmoral Ave, Chicago, IL 60630) you, the Client, agree to the follow terms:

Description of Coaching

The coaching service is a relationship where Twenty-One Senses partners with clients to empower them as caregivers and to foster the client’s ability to nurture their child’s academic growth, executive function, resilience, and emotional regulation. Over time, clients can expect to iteratively improve their ability to understand their child’s developmental trajectory and to work within real-world constraints to create and maintain their child’s physical, emotional, and intellectual environment.

Basic Terms

Twenty-One Senses agrees to maintain the ethics and standards of behavior established by the International Coach Federation, available for review at The Client acknowledges and agrees:

  1. The Client’s willingness to communicate honestly, to be open to feedback and assistance, and to create the time and energy to participate fully will influence the amount of benefit they receive from the experience.
  2. The Client is solely responsible for all decisions they make including choices about their own well-being, their family, this coaching relationship, and how to handle any recommendations or input they receive.
  3. Twenty-One Senses is not liable for any result or non-result or any consequences which may come about due to this coaching relationship.
  4. Caregiver Coaching is not therapy, does not substitute for therapy if needed, and does not diagnose, prevent, cure, or treat any mental disorder or medical disease. Coaching is not to be used as a substitute for professional advice by legal, medical, or other licensed professionals. It is the Client’s exclusive responsibility to seek such independent professional guidance as needed.
Standard Fee

The standard fee for Caregiver Coaching is $100 per 50-minute session and is due at time of service. Payment may be made by credit card or bank transfer. Sessions cancelled with less than 24-hour notice will be billed at the standard rate.  Fees paid are non-refundable.

As life-long social justice advocates, we feel strongly that Caregiver Coaching should be accessible to anyone who wants it. Twenty-One Senses is proud to offer a sliding scale pricing model. If interested in the sliding pay scale, please mark the checkbox and fill out the additional details, when signing the client service agreement.  Once the requested information is received, Twenty-One Senses will respond with details of the modified session fee.

Twenty-One Senses is a not-for-profit charity dedicated to empowering parents and caregivers of children with disabilities. When you pay our standard fee, you fully cover the cost of the service you receive. We never make a profit.

When you cover our costs, you allow us to use our revenue from donations and grants to make our services available to a wider range of parents and children.

Consider arranging a more affordable fee if you:

  • are unemployed, underemployed, or work multiple jobs to make ends meet
  • stress about meeting basic needs such as food, shelter, childcare services, and healthcare
  • have limited access to financial savings 

Please consider paying our standard fee if your family:

  • consistently spends well over $100/week on discretionary expenses such as recreation, entertainment, hobbies, etc.
  • wishes to support our mission to serve the maximum possible number of families who are in need

Twenty-One Senses will never disclose confidential personally identifying information without the Client’s express written consent. All information (documented or verbal) that the Client shares with Twenty-One Senses as part of this relationship is bound by the International Coach Federation Code of Ethics’ Principles of Confidentiality. 

Twenty-One Senses regularly engages in training, research, grant writing and other activities consistent with its not-for-profit mission to empower parents and caregivers of children with disabilities. The Client acknowledges this fact and provides informed consent for Twenty-One Senses to disclose strictly anonymous Client information to further its charitable, mission-aligned activities. 

Confidential Information does not include information that (a) Twenty-One Senses is required to disclose by law; (b) leads Twenty-One Senses to reasonably believe there is an imminent or likely risk of danger or harm to the Client or others; or (c) involves illegal activity. The Caregiver Coaching relationship is not considered a legally confidential relationship (like the medical and legal professions) and communications are not subject to the protection of any legally recognized privilege.

Other Legal Stuff

This document reflects the entire agreement between Twenty-One Senses and the Client and reflects each party’s complete understanding of the Coaching Client Service Agreement. This Agreement takes the place of all prior written and oral agreements. Changes to the agreement must be made in writing and both parties need to accept the changes in writing .  A failure to enforce any part of this Agreement at any point in time will not waive any rights or obligations for either party at any later date. This Agreement is governed by laws of the State of Illinois and is binding upon the parties, their successors, and their assigns.