Consent to Participate in Adult Support Groups

Our Commitment to You:
The Epilepsy Association of Calgary (EAC) provides educational and skill-based group programs to the community and offers a safe virtual environment for group participants.

EAC protects your privacy. We do not tell people if, or why, you are seeking our services. All information shared by the participants in support groups should be kept confidential within the group. As a participant you can support confidentiality by ensuring you are in a quiet and private location. The use of headphones is advised.

There are times when the facilitator or counsellor may not be able to protect your privacy out-lined below. Some important limits to confidentiality include when:

  • you share informatioThe Epilepsy Association of Calgary (EAC) provides educational and skill-based group programs to the community and offers a safe virtual environment for group participants.n that implies you are in imminent danger of harming yourself or someone else, someone you know may be in danger, or a child or vulnerable adult is being abused.
  • you give us written permission to share details about you to others. You have the right to change your mind and revoke that permission at any time.
  • we use non-identifying facts about you to compile statistics that may be used in professional publications and/or presentations.
  • your Participant File is subpoenaed. We may advocate limiting the information admissible, but the court system has the ultimate right to access your Participant File.

Participant File:
After you complete the Consent to Participate in Adult Support Group form, a Participant File will be created. Participant Files are created, managed, retained and destroyed in accordance with EAC’s Filing Policy. A copy of our Filing Policy is available upon request. Participants may wish to note that once created, Participant Files are retained for a period of 10 years following the last day of service after which time they are destroyed. Participants may request a copy of the Participant File.

Special Considerations Regarding Virtual or Online Services:
EAC offers services (telecounselling) through distance delivery via video conferencing or telephone. The platform we use for video conferencing is Zoom1. Zoom is a third-party video communication service.

Some risks are specific to virtual groups. These include such things as: interruptions, risk of distractions, unauthorized access, time delays, equipment failure and technical difficulties, others overhearing the conversation, and the potential for insecure connections such as accessing free (public) Wi-Fi services. Participants are advised to check with their home internet service providers to ensure security is up to date and to check that privacy settings and features are enabled as appropriate.

EAC is not responsible for any data overage fees accrued related to participation in support group programming. These fees are the participants’ sole responsibility.

Requests to Support Program Evaluation:
EAC conducts regular evaluation of its programs. Participation is voluntary. Any information you provide will be kept confidential, used only for the purposes of evaluating the program, and will not be used in any way that can identify individual participants.

[contact-form-7 id=”3530″ title=”Consent Form Adult Support Group”]

Please remember to complete the GROUP EXPECTATIONS form as well.

Do you have an idea for a workshop? Or a suggestion for our new peer support program?

We want to hear from you! Call 403-230-2764, ext 105 or email us your idea.

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