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Confidentiality Agreement

Please read and sign our confidentiality agreement below.

Confidentiality agreement:

You agree not to disclose, or in any way use any confidential information obtained in your discussions with participants, except as required by law and only in connection with this program. “Confidential Information” means all materials, information related to the program, or information about participants in the program in any form (and howsoever gathered or stored), disclosed to you. Information you learn about participants in this program may include information about their health and personal life. This information must be held in strict confidence and not shared with you by anyone without consent of the participant or as required by law.

Limits of confidentiality are as follows:

  1. There are reasonable grounds to believe that you are likely to harm yourself or another person.
  2. where disclosure is required where there are reasonable grounds to suspect that a child is in need of protection due to physical harm, neglect or sexual abuse by a person having charge of the child;
  • Your records have been subpoenaed by a court of law.
  1. for the purpose of contacting a relative, friend or potential substitute decision-maker of the individual, if the individual is injured, incapacitated or ill and unable to give consent personally
  2. You disclose that you have been sexually abused by a regulated health professional.

I acknowledge the nature of my voluntary role and hereby release, acquit and forever discharge MNC, its officers and directors, and its employees, agents and insurers from any and all claims, responsibility of liability of whatever kind which may be sustained as a result of my participation

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