Online Support Group

Name:
Email:

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Support group attendance is recommended, not required and my participation is voluntary.

I am aware of the confidentiality policy and by clicking on the link to join the Zoom meeting I acknowledge that I have read the statement below.
 
I understand that in a support group, group members will be expected to uphold one another’s confidentiality. I understand that all information disclosed within the group meeting is confidential and I agree not to reveal information learned about other members. I agree that I will participate in the online group from a private location where other individuals will not be able to see my screen or hear the audio from the meeting. I also agree that I will not record or attempt to record the content of the support group. I understand that there are certain risks related to my participation in an online support group. These risks include that other members of the support group may not abide by these confidentiality rules and may share information about me or my participation in the group. I understand that Northern Light Eastern Maine Medical Center cannot control and is not responsible for the conduct of other members of the support group. I understand that my participation is voluntary, and that I can stop participating at any time.
 
During support group my microphone will be muted. My camera will be enabled, and it will be my responsibility to disable the camera if I prefer not to be viewed.

I agree: