This Service Agreement between the Client (yourself), your Mentor/ Life Coach / Counsellor and Prism Counselling
will be valid for the duration of your Mentoring / Life Coaching / Counselling engagement with Prism Counselling
and will apply to all the services availed of by you including, but not limited to, individual mentoring/counselling/lifecoaching, couple/marital counselling/life-coaching, family therapy and any personality/mental state assessments or
tests you may undertake with Prism.

Please read the terms and conditions of this agreement and confirm your acceptance at the bottom of the page.
1. Confidentiality: The mentoring/counselling/life-coaching session will be conducted under strict
confidentiality adhering to the global code of ethics of the counselling and life-coaching professions. Your
counsellor/life-coach will not disclose your identity or discuss the details of your case with anyone unless
certain exceptional circumstances prevail that require them to breach confidentiality as explained in the
next clause. The counsellor/life-coach may or may not inform you in advance in the rare event that they
need to break confidentiality.
2. Breach of confidentiality: Exceptional circumstances under which the counsellor/life-coach will need to
inform a doctor, a responsible person in your family, your organisation or any other appropriate entity are:
i) If the counsellor/life-coach believes you are at risk of seriously harming yourself, injuring someone
else or at serious risk of being harmed by someone else
ii) If during the counselling/life-coaching session, it becomes evident that you have committed or
intend to commit a crime such as robbery, child abuse, sexual abuse, murder or terrorism
3. Maintaining records: Detailed records of your sessions, as well as any homework assignments or selfreflection tasks that you may have submitted, will be stored confidentially by your counsellor/life-coach.
4. Modes of communication: You can avail counselling/life-coaching through various modes: (a) in-person at
the counsellor/life-coach’s office or any other appropriate mutually agreed location and/ or (b) via an
audio/video online platform such as Zoom, WhatsApp, Teams, etc. You can discuss and agree with your
counsellor/life-coach your preferred mode of communication, which can change from one session to the
next.
5. Scope of services: The types of issues Prism Counselling helps clients with are usually everyday mental
health issues such as inter-personal relationships, workplace challenges, family conflict, marital discord,
stress & anxiety, loneliness & depression, fears & phobias, low self-esteem or self-confidence, parenting
challenges, etc. The counsellor/life-coach may choose to adopt an integrative approach incorporating
different techniques of counselling, psychotherapy or life-coaching with the single-minded purpose of
helping and supporting you, the client, and for achieving any session goals that may have been agreed. The
counsellor/life-coach will explain and discuss their approach with you from time to time.
Prism Counselling currently does not provide legal counselling, financial counselling, clinical counselling or
psychiatric treatments. In case a client needs such specialised help, your counsellor/life-coach will refer you
to an appropriate professional.
6. Referral: If your counsellor/life-coach believes that a psychiatrist, doctor or some other professional would
be better placed to help you, he/she will suggest a referral and will support you through the transition to
another professional, as needed. If the client desires to switch to only in-person sessions and the
counsellor/life-coach is unable to provide them, he/she will support you through the referral and transition
process.
7. Duration of session: Each counselling/life-coaching session will be of 45-60 minutes duration. If the session
is shorter than 40 minutes due to delay or any other issue at the client’s end, the full session fee will be
charged. However, if the counsellor/life-coach is responsible for the shorter duration (less than 40 minutes),
you can ask for a proportional refund of fee.
8. Fee structure: The fee for 45-60m counselling session is as per prevailing rates mentioned on the Prism
Counselling website (https://prismcounselling.com/counselling-fees/) or as mutually agreed with the
counsellor/coach.
9. Payment: Payment is due in advance of an agreed counselling/life-coaching session and can be made using one
of the following methods:
i. Cheque in favour of Prism Counselling
ii. Online bank transfer to Prism Counselling as per bank details below:
Bank details:
Account Name Prism Counselling
Account number 165205000108
IFSC code ICIC0001652
SWIFT code ICICINBBCTS (for foreign currency remittances)
Bank name ICICI BANK LIMITED
Bank branch GOLF COURSE ROAD BRANCH
10. Planned/Unplanned breaks: Your counsellor/life-coach may be on leave from time to time and if so, will
give adequate notice to you. Similarly, you will need to give advance notice to your counsellor/life-coach if
you need to take a break from counselling/life-coaching for a few days owing to a holiday or some other
commitments or reasons. If you cancel or miss a session without sufficient notice, the full session fee will
have to be paid by you. If the counsellor/life-coach misses a session without prior notice to you, you will
not be charged for that session.
11. Disclosure: It is always advisable to be completely honest with your counsellor/life-coach so that they can
help you to the best of their abilities and you can maximise your potential benefits from their services. In
addition to full and honest disclosure, it is critical that you share the following information with your
counsellor/life-coach:
i. any past experience you may have of counselling, psychotherapy or life-coaching
ii. any medications you may be taking currently or have done in the recent past
iii. any mental health issue you may have – whether or not you have had treatment for it in the past
iv. any family history of mental health illness
v. if you are being physically abused by someone
vi. if you fear for your safety
vii. if you have suicidal thoughts
12. Continuity: Once you have signed up for counselling/life-coaching services with Prism Counselling, you will
have the same counsellor/life-coach for all your sessions so you can gain maximum benefit from their
services.
13. Dissatisfaction with counsellor/coach: If at some point you are dissatisfied with your counsellor/life-coach
and would like a change, you can request for a change of counsellor/life-coach, providing clear reasons for
your dissatisfaction.
14. Legislation: This agreement will be governed and construed in accordance with prevalent laws in India in
NCR. In case of any conflicts between the 2 parties Client (yourself) and your Counsellor/Life Coach, the
legal frameworks in NCR, India will be used to manage or resolve such conflicts.
I agree to the terms and conditions of this Service Agreement.
Name: _________________________________________________
Signature: ______________________________________________
Date: __________________________________