Adult Grief Support Group Informed Consent
Confidentiality: Your confidentiality is of the utmost importance to us. As your group facilitators, we will keep what you share confidential. There are only a few times when we are required to break confidentiality. These situations are as follows:
1. If we feel you are in danger of harming yourself or others, we are obligated to take action. Every effort will be made to work with you and inform you first in such instances.
2. If an instance of previously unreported child or elder abuse is brought to light, Montana State Law requires us to report this.
TGRC does not offer 24-hour or crisis care. If you or someone you know requires emergency care after business hours, please call 911. If you or someone you know would like to be connected to a mental health resource 988 is available 24 hours a day. Please do not bring pets or children to the group as they can be distracting during your time of processing grief. Thank you for adhering to this informed consent. We look forward to the group process with you. If you have any questions, please feel free to ask.
Assumption of Risk and Waiver of Liability and Medical Authorization
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I recognize the potentially severe injuries, including permanent paralysis or death can occur in sports activities including but not limited to, ropes courses, team sports, swimming, and boating. Being fully aware of these dangers, I voluntarily consent to participating in any and all Tamarack Grief Resource Center programs, camps, and activities and I accept all risks associated with that participation.
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I, on my own behalf and our respective heirs, administrators, executors and successors, hereby covenant not to sue and forever release Tamarack Grief Resource Center, its officers, directors, employees, or agents from all liability for any and all damages or injuries suffered by myself at Tamarack Grief Resource Center.
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In the event of an accident or emergency I would like to be taken to the hospital for medical treatment and I hold Tamarack Grief Resource Center harmless in their execution of this action. I hereby agree to individually provide for any possible future medical expenses, which may be incurred by myself as a result of any injury sustained while participating in any Tamarack Grief Resource Center program or activity.
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I give permission for publicity, educational or social media use of any photos or video taken at any and all Tamarack Grief Resource Center programs or events. (We rarely take identifying photos in a closed support group setting, and we will always ask for your permission before taking or sharing any such photos.)
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I give consent to be added as a contact to a newsletter mailing.
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Finally, I will hold Tamarack Grief Resource Center harmless for loss or theft of personal items taken to any Tamarack Grief Resource Center program or activity.
I have read and understood this assumption of risk and waiver of liability and medical authorization and I voluntarily affix my name in agreement.
“I have read and discussed the above information.”
