Thank you for choosing Cascade Mental Performance. This form helps us understand your athlete’s goals, performance needs, sport background, and relevant support considerations. Please review the agreement carefully before booking services. If you have questions, discuss them with your mental performance consultant before submitting this form.
Services
Cascade Mental Performance provides applied mental performance coaching and sport psychology services for athletes, young adults, parents, families, coaches, and teams. Services may include mental skills assessments, individual performance coaching, sport-parent consultations, team workshops, coach education, and related performance consultations.
These services are educational and performance-focused. They are not medical or psychiatric treatment, and clients are not patients under our care. Services may not be covered by health insurance.
Results cannot be guaranteed. Progress depends on the athlete’s participation, effort, collaboration, and the involvement of parents, coaches, and other relevant support professionals.
Clients may stop services at any time. A final consultation may be recommended to discuss concerns and determine whether additional or alternative support would be helpful. The professional relationship must remain within appropriate professional boundaries.
Minors and Legal Authority
If the athlete is under 18, the signing parent or legal guardian confirms that they have the legal authority to consent to these services, whether through sole legal custody, shared legal custody, or legal guardianship. Parents or guardians are responsible for complying with any applicable court orders.
Scope of Practice and Referrals
Cascade Mental Performance services do not replace medical, psychiatric, psychological, or emergency care. If clinical concerns arise, the consultant may recommend consultation with or referral to an appropriately licensed healthcare professional.
Confidentiality
Information shared with Cascade Mental Performance will be treated as private. Information will not generally be released without written permission, except where disclosure is required or permitted by law.
Limits to confidentiality may include:
A serious and imminent risk that the client may harm themselves or someone else.
Suspected abuse or neglect that must be reported under applicable law.
A valid subpoena or court order.
Professional consultation, when identifying information is not disclosed.
Administrative communication required to operate the practice.
Email and text messaging should be used primarily for scheduling and administrative communication and may not be fully secure.
Teens and Young Adults
For athletes under 18, parents or legal guardians may have rights to receive general information about progress. Cascade Mental Performance will aim to maintain a collaborative relationship with the athlete and family.
Athletes age 18 or older control access to their information. A written release may be requested before discussing general progress with parents or guardians.
Financial Agreement for Services
Payments are due at the time of service. A fee of $25 will be added to any account that has not been paid within 60 days of the initial billing date. An additional $10 fee will be charged for each month that the account continues to be unpaid. If your account has not been paid for more than 60 days, and arrangements for payments have not been agreed upon, we have the option of using legal means to secure the payment. This may involve a collection agency or small claims court, which may require us to disclose otherwise confidential information. In most situations, the only information we release regarding a client is his/her name, nature of services provided, and the amount due. If such legal action is necessary, its costs will be included in the claim. Please note that our fees are subject to change at any time.
Emergencies
Cascade Mental Performance does not provide emergency mental-health services. In an emergency, call 911, go to the nearest emergency department, contact the athlete’s physician or mental-health provider, or contact an appropriate local crisis service.