Coaching Intake & Agreement

Before our initial session, please review and complete both the intentional intake questionnaire and our client liability release below.

Document I: Client Intake Questionnaire

Strictly confidential. Informs session pacing, safety baselines, and custom goal orientation.

Full Legal Name

Preferred Name / Pronouns

Email Address

Phone Number

Date of Birth

City, State / Timezone

Emergency Contact (Full Name, Relationship & Phone)

Primary Life / Professional Objectives for Coaching

Current Frequency of Cannabis Use

Primary Consumption Method

Session Setting Preference

Experience with Greening Out, Anxiety, or Tolerance Management

Health & Medication Screening

Document II: Informed Consent & Liability Waiver

Please read the terms below carefully. Acceptance is mandatory for participation.

1. Non-Medical and Non-Therapeutic Scope of Practice

Coaching services provided by Cansulting do not constitute medical advice, psychiatric assessment, psychological therapy, addiction counseling, or clinical diagnosis. The practitioner is an intentional life and lifestyle coach. The client assumes full personal agency for all health and wellness decisions.

2. Zero Dispensation & Sourcing Warranty

Cansulting does not sell, provide, dispense, transfer, or prescribe cannabis, cannabis derivatives, or paraphernalia. The client warrants that any substance in their possession was lawfully obtained under applicable local/state laws. All consumption is undertaken at the client's sole discretion and legal liability.

3. Impairment, Safety & Transportation Policy

The client strictly agrees NOT to drive, operate a motor vehicle, or handle dangerous equipment for at least 4 to 6 hours after any session in which active consumption occurs. The coach maintains full discretion to suspend or terminate any session immediately if the client presents signs of acute distress or incapacitation.

4. Voluntary Assumption of Inherent Risk

The client understands that cannabis consumption carries potential physiological and cognitive effects, including altered perception, accelerated heart rate, lethargy, or anxiety. Participation is voluntary, and the client accepts full responsibility for all outcomes.

5. Release of Liability and Covenant Not to Sue

The client releases Cansulting, its owners, contractors, and agents from any and all claims, demands, liabilities, or lawsuits resulting directly or indirectly from life coaching insights, lifestyle guidance, or self-directed cannabis consumption.

I understand and confirm that this coaching is not medical care, psychiatric diagnosis, or psychotherapy.

I agree not to drive or operate machinery for at least 4–6 hours post-consumption.

I have read and fully agree to the Terms, Informed Consent, and Complete Release of Liability above.

Digital Signature (Type Full Legal Name)

Date Signed