• By signing this form (please type in your name below), I agree the information on this document is true and complete and understand information shared in my Care group will be kept confidential by group leaders, except as required by law, and that there is no guarantee confidence will be maintained by other group members. I understand this program is not counseling or therapy, but is faith-based and volunteer-led to help people heal in a group setting. Information provided on this form is confidential and will only be shared with Care Coaches and Leaders.
  • Date Format: MM slash DD slash YYYY