Salisott Parent Coaching & Certification

Laugh More. Yell Less. Lead with Confidence. 

The world is changing—and your parenting strategies should too.
Whether you're raising littles or leading other parents, it's time for a new approach that actually works.

Ready to transform the way you parent (or coach)? Start here. 

Parent Coach Intake Form

INTRODUCTION:  This Parent Coaching Policies and Agreement ("Agreement") includes vital information about the professional services offered by Salisott Parent Coaching and Certification LLC ("Salisott PCC") and its related business policies.

It is important that you review this Agreement carefully.  In agreeing to move forward with services, you understand that our team are parenting professionals not licensed therapists. As such, you will seek a licensed counselor/therapist to process anything that may arise, personally, in the process of working with Theraplay™ principles and other trauma and attachment-based coaching.  

We can discuss any questions you have about the terms set out below. When you sign this Agreement, it will represent a binding contract between us.  

SERVICES:  A parent coach’s job is to motivate and guide you toward being the parent you want to be. Parent coaching is customized support to help you identify what matters most to you as a parent and then make needed adjustments in your parenting.  

Salisott PCC offers the following services:

• One on One (or 2) parent coaching services utilizing evidence-based principles.
• Group Parenting Classes
• Visit engagement/supervision for the purpose of increasing parenting skills and connections with the child.
• Marschak Interaction Method evaluation.  

Salisott PCC utilizes engaging activities that are based on Theraplay™ principles as well as other evidence-based research focusing on trauma, attachment, parenting styles and engagement, as well as trauma informed care.

In Theraplay™ the parent and child are guided through a series of fun and engaging games and activities that are designed to be developmentally challenging as well as tender and nurturing.  

Salisott PCC's approach is built upon:

• Collaboration. Your expertise as a parent is an essential part of the success of the coaching partnership. No one knows your kids the way you know your kids, and that knowledge is key to effectively addressing the challenges you face.
• Future-focused and action-oriented. You need to know where you are going if you want to make sure you get there. Do you want to stop yelling at your kids? Help your child become more confident? Feel less overwhelmed by the demands of a hectic schedule? We will set goals to solve problems like these.
• Strength-based. Coaching helps you identify your unique strengths, skills, and resources. What we focus on grows; approaching challenges from a foundation of strength allows you to use your skills effectively while maintaining the positive outlook that allows for growth.
• Customized. There is no “one size fits all” in parenting. You are unique, your family is unique, and each situation will be assessed independently.  

In sum, our coaching is designed to lead to better parent-child relationships with reduced stress and distress.  

However, as with other professional services, our coaching may not always work and there are no guarantees with respect to a successful outcome. You always have the right to ask about our professional experience, background, and Salisott PCC's Theraplay™ orientation.    

CONFIDENTIALITY Parent Coaching might include discussion of private matters.  Accordingly, with some limited exceptions, Salisott PCC will not reveal client information to anyone else or send out information about a client without the client's permission.

If you ask that private information be shared with someone else (e.g., your physician), you may be required a written Authorization form. We will talk about this before you sign the consent.

As noted, there are exceptions to Salisott PCC's general rule of confidentiality.  In addition to disclosures that may be made pursuant to a written authorization signed by the client, such exceptions include, but are not limited to, the following situations: (i) a client threatening to harm herself/himself or someone else, (ii) a client revelation or a reasonable suspicion by Salisott PCC that any child may be subject to abuse or neglect, and (iii) if information must be disclosed pursuant to a subpoena or a court order.  

If you have any questions regarding the use and/or release of client information, please bring them to our attention.  

ACKNOWLEDGMENT AND WAIVER OF CERTAIN CLAIMS  THE UNDERSIGNED HEREBY ACKNOWLEDGES THAT THE THERAPY-RELATED ACTIVITIES PROVIDED BY SALISOTT PCC ARE NOT INTENDED AS A SUBSTITUTE FOR MEDICAL OR PSYCHOLOGICAL TREATMENT AND THAT ALL TIMES THE INTERACTIVE COACHING PROVIDED BY SALISOTT PCC WILL BE RESTRICTED TO CONSULTATION THAT DOES NOT INVOLVE THE DIAGNOSIS OR TREATMENT OF ANY ILLNESS.  I FURTHER UNDERSTAND THAT I HAVE THE RIGHT AND OPPORTUNITY TO DISCUSS THIS ACKNOWLEDGMENT AND WAIVER OF CERTAIN CLAIMS PRIOR TO SIGNING AND THAT BEFORE SIGNING I MAY OFFER ALTERNATIVE PROVISIONS OR ARRANGEMENTS FOR CONSIDERATION BY SALISOTT PCC.

ACCORDINGLY, BY SIGNING BELOW AND IN CONSIDERATION OF THE OPPORTUNITY TO PARTICIPATE IN THERAPY-RELATED ACTIVITIES INVOLVING SALISOTT PCC (THE "THERAPY ACTIVITIES"), I, FOR MYSELF AND MY HEIRS, ASSIGNS, EXECUTORS, AND ADMINISTRATORS, AGREE THAT SALISOTT PCC AND ITS OFFICERS, DIRECTORS, MEMBERS, EMPLOYEES, ASSISTANTS, AGENTS, AND REPRESENTATIVES (THE "RELEASEES") SHALL NOT BE LIABLE, JOINTLY OR SEVERALLY, FOR ANY INJURIES I MAY SUFFER IN CONNECTION WITH THE THERAPY ACTIVITIES, TO THE EXTENT SUCH INJURIES ARE CAUSED BY THE NEGLIGENCE OF THE RELEASEES.  TO THE FULLEST EXTENT PERMITTED BY LAW, I HEREBY VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY SUCH RISK OF LOSS WHICH MAY BE SUSTAINED BY ME AS A RESULT OF BEING ENGAGED IN SUCH THERAPY ACTIVITIES AND CAUSED BY THE NEGLIGENCE OF RELEASEES AND WAIVE ALL SUCH CLAIMS AGAINST THE RELEASEES.  THIS WAIVER DOES NOT PRECLUDE CLAIMS BASED ON ANY RECKLESS OR INTENTIONAL CONDUCT ON THE PART OF THE RELEASEES.

Please complete this form in advance of your initial parent coaching session. Feel free to reach out with any questions you may have. Thank you!  Salisott PCC

By filling out this form you CONSENT FOR TREATMENT:  You understand and agree to all the terms and conditions set out in this Agreement.  

You consent to participate in Parent Coaching with Salisott PCC and acknowledge that Salisott PCC utilizes Theraplay™ principle you understand that we may discuss the benefits, risks, alternatives, and nature of the coaching being provided by Salisott PCC.  You acknowledge the importance of active participation in Parent Coaching, but that Salisott PCC does not guarantee any specific results.    

Your completing this form indicates that you have read and understood the Agreement.