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Agreement of Confidentiality 
The confidentiality of your health information is important to the Young Survival Coalition. As a Virtual Hangout Participant, you will be heard by other members in the group.

In the Virtual Hangout, you should only share information you are comfortable sharing. There is no requirement to share personal medical information. By checking the 'Agreement' box below, you acknowledge that you may choose to discuss personal information related to your condition in a support group setting and acknowledge that the facilitators do not have control of how others in the group do or do not protect your information. By checking the box below, you also agree to respect the confidentiality of the other members of the group by not revealing medical or any other identifying information after the session is over, and that you will not hold the Young Survival Coalition or facilitators responsible for any breach of confidentiality committed by other members of the group.

Please reach out to Jean Rowe at jrowe@youngsurvival.org with any additional questions.