Support Group Consent

When attending a support group at Jasper Therapy Group, you will be asked to sign a support group consent form. The form reads as follows:

I authorize and request that Jasper Therapy Group provide me with support group services. I understand that there will not be any diagnostic procedures or examinations during the course of my participation in the support group.

Confidentiality

All information disclosed within sessions is confidential and may not be revealed to anyone without written permission, except where disclosure is required by law. Disclosure may be required in the following circumstances: where there is a reasonable suspicion of child abuse, vulnerable adult, or elder adult abuse; where there is a reasonable suspicion that the participant presents a danger of violence to others or where the participant is likely to harm him or herself, unless protective measures are taken. Disclosure may also be required pursuant to legal proceeding.

The Support Group Process

These groups are designed to be supportive and to provide psychoeducational skills and some practice of these skills. This is not group therapy in the sense of process groups or individualized work. These Groups are designed to be Supportive in Nature, but at times a member can experience some discomfort. If this were to happen, please contact your therapist or take steps to sign up for mental health therapy.

Signatures Verifying Agreement: Your signature below indicates that you have read the information in this document that you have understood it, and that you agree to abide by its terms as long as you are attending the support group.

Participants who refuse to sign the consent form will not be permitted to attend or participate in the support group.