This signed consent form demonstrates your agreement to participate in the YAS Support Group. We are an open support group. We ask that members of the group maintain the confidentiality of other members, however, recognize that we can not guarantee this and it is contingent upon each members respect and understanding of one another’s need for safety and privacy.
a. If we come to believe that you are threatening serious harm to another person, we are required to try to protect that person. We may have to tell the person and the police, or perhaps refer you to be psychiatrically screened.
b. If you seriously threaten or act in a way that is very likely to harm yourself, we may refer you for psychiatric screening, or to call on your family members or others who can help protect you. If such a situation does come up, we will fully discuss the situation with you before we do anything, unless there is a very strong reason not to.
c. In an emergency where your life or health is in danger, and we cannot get your consent, we may give another professional some information to protect your life. We will try to get your permission first, and we will discuss this with you as soon as possible afterwards.
d. If we believe or suspect that you (or another minor or elderly person) are being abused. We must report this to the NJ Abuse to further investigate.