I understand that by submitting my interest and by attending QuickMD’s Peer Support Group Sessions (“Group Sessions”), my Protected Health Information, including but not limited to my name and/or identity, may be revealed to other Peer Support Group Members (“Members”) attending the Group Sessions for the sole purpose of participating in peer-led group support sessions. Additionally, I understand that I may be exposed to other people’s Protected Health Information during Group Sessions. I understand that I may leave at any point of my choosing. I release QuickMD from liability for the exposure of any Protected Health Information, including my name and/or identity, that was shared in these Group Sessions, both during and after the completion of these Group Sessions.
Confidentiality
QuickMD respects each and every Member’s right to privacy and confidentiality, and shall take precautions to ensure that discussions that take place within Group Sessions are confidential. However, please understand that this is not absolute and is limited to provide for by law. Certain limitations are as follows:
Threatening one’s self or another that will likely result in physical harm;
An act of physical or emotional abuse against a child or any other person;
Sexual abuse against a child where the child is living with the abuser;
Summons by court order to disclose information against a participant. However, we shall notify you and let you exercise your privilege in the right to deny the disclosure of your records with us; and your prior written consent to release records. Please note that this consent can be revoked by providing formal notice to QuickMD. Revoking consent cannot prevent past disclosures, but will prevent future disclosures.
Rules of Conduct
To protect Members of the QuickMD Peer Support Group program as much as possible, it is necessary that all Members are expected to fully comply by the following rules of conduct:
- Any and all discussions that occur within group sessions are not allowed to be discussed outside of the group with any Member or non-Member of the Group, and all Members should maintain strict confidentiality to abide by the rules of this Agreement;
- While certain sessions may involve emotional and potentially difficult conversations, Members are asked to attempt to stay positive and to not induce disrespect among other Members;
Members are expected to maintain absolute sobriety prior to and during all sessions; - Members shall maintain conduct that is respectful to fellow Members’ thoughts, emotions, stories, and behaviors; and
- Members shall not communicate, or attempt to communicate, with other Members outside of Group Sessions without the consent of all parties involved. Failure to respect the privacy of other Members outside of Group Sessions will result in immediate dismissal from all future Group Sessions. If consenting group Members wish to communicate outside of Group Sessions, they are free to do so. However, QuickMD will not be liable for the release of any information that occurs outside of a Group Session, nor will QuickMD be liable for any event or action that occurs outside of a Group Session. Additionally, due to the technical limitations of Google Meet, please note that coordinating communication with a fellow Group Member during a Group Session will likely result in your information being revealed to the entire Group as well as your intended audience. Please proceed at your own risk.
By expressing interest in a Peer Support group with QuickMD, I affirm that I have read all the aforementioned information and release QuickMD from liability for the exposure of any Protected Health Information that was willingly shared by me to other Members attending Group Sessions.