Terms and Conditions – ORIG

Radiant Parent Membership Program
Terms and Conditions

Welcome to Discover Hope’s Radiant Parent Program! We are thrilled at the opportunity to be able to help and support you and your family.

The Radiant Parent Program (RPP) is a product of Discover Hope Behavioral Solutions Inc. (Discover Hope). Individuals who sign up for a membership through the RPP are referred to as “members.” Employees of Discover Hope are referred to as “staff.” Your use of RPP is governed by these Terms and Conditions (“Terms”), and you hereby expressly agree to be bound by the Terms.

Purpose and Intent of Membership
The Radiant Parent Program (RPP) provides general education about behavior management strategies and support to parents and caregivers. RPP is designed to help caregivers to become the best caregiver they can be, and to help children reach their full potential. RPP uses evidence-based strategies designed and supervised by Board Certified Behavior Analysts (BCBA) and/or a Licensed Marriage and Family Therapist (LMFT).

The Radiant Parent Program does not provide medically necessary services. Services provided through this membership are not considered covered medical services. It is the member’s responsibility to first go through their child or family’s medical practice and insurance to exhaust all covered services available before seeking supplemental services such as RPP.

Membership Structure
Members can join RPP at one of three levels: Lite, Essential, and Exclusive. Each level provides a different level of services and support. Each member is issued credits each month on their renewal date and are able to use those credits to purchase the services available in their level of membership.

Membership Terms
Your membership renewal date will be the day of the month that you first signed up. Your membership will automatically renew each month on that day, and your account will automatically be given credits based on the membership level you signed up for. Credits do not roll-over, any unused credits will expire on the renewal date. There are no refunds. Memberships may be canceled at any time. When a member cancels a membership, they will continue to have access to their account and credits until the renewal date, at which point they will no longer have access to the membership program. Discover Hope may terminate this Agreement with immediate effect, without a written notice to the member, if the member (1) fails to pay any amount when due under this Agreement, 0r (2) has not otherwise performed or complied with any of the term of this Agreement, in whole or in part.

Members can upgrade to a higher level at any time, and pro-rated additional credits will be added to the account until the next renewal date. If a member wishes to downgrade to a lower level, they must do so at least 5 business days before their next renewal date.

Member Candidates
The Radiant Parent Program is a resource for parents and caregivers in managing their child’s challenging behaviors and teaching children positive and appropriate skills. Discover Hope’s RPP serves its members without discrimination based on race, religion, color, national or ethnic origin, sex, age, sexual orientation, mental or physical disability, or any other protected category.

Northern California Kaiser Patients
If your child has Northern California Kaiser insurance AND you are currently receiving ABA services for that child, we do not recommend that you participate in the RPP program. Discover Hope has contractual limitations that do not permit us to discuss or advise on any matters related to that child. You are able to purchase date night time separate from a membership.

ABA Clients
If your child has received ABA services in the past but is not currently receiving services, we recommend you exhaust all medically covered services before joining RPP. If your child is currently receiving ABA services (from any funding source except Northern California Kaiser) you may participate in the Lite or Essentials package but we cannot provide you with Behavior Consultation services. While ABA clinical supervision and the Behavior Consultation services are different services with a different purpose, receiving both at the same time may lead to unnecessary confusion and overlap. The Radiant Parent Program is designed to supplement any other services you have received in the past or are currently receiving, and is not intended to replace or take over current medically necessary services.

Scheduling and Cancellations
The Radiant Parent Program offers many individual services that will be scheduled based on your availability and staff availability. Appointments must be cancelled with at least 24 hour notice. If less than 24 hours notice is provided by you, it will not be rescheduled and no credits or money will be refunded. If at any point Discover Hope cancels an appointment, Discover Hope will return the credits back to the member. Membership in RPP does not guarantee the availability of any particular service on any particular day or time. Scheduling requests are handled dynamically via the RPP website and subject to availability.

Sick Policy
Discover Hope makes every effort to keep all of its members and staff healthy and to prevent the spread of illness. In person appointments must be cancelled if anyone attending the appointment has exhibited any one of the following symptoms within the last 24 hours:
A temperature of 100 degrees or higher
Diarrhea (2 occurrences)
Vomiting (1 occurrence)
Any rash other than diaper rash
Eye infection
Bad cold with hacking or persistent cough, productive cough with green or yellow phlegm being coughed up.
Nasal discharge that is either green or yellow
Extreme irritability or exhaustion
Children must be fever-free for 24 hours without the use of Tylenol (or similar medications) before participating with staff members

Professional Relationship
Ethical Guidelines
All Discover Hope staff persons abide by the ethical guidelines of the Behavior Analysis Certification Board. Some staff persons also abide by the ethical guidelines of the Board for Behavioral Sciences.

Members are not required or expected to provide any food or beverages to Discover Hope staff at any time. The staff person will usually decline offers for food and drink unless it would be considered rude to the member’s customs and cultural expectations.

Discover Hope staff may NOT accept gifts of monetary value.

RPP Members may not employ or work with Discover Hope staff members in any other capacity while receiving services from Discover Hope for at least one year following termination of either party’s relationship with Discover Hope.

Discover Hope Staff are mandated reporters and are required by law to report any reasonable suspicions of abuse and/or neglect of any child in a home/school/community setting.

Safe and Harassment Free Working Environment
Some of the services of the Radiant Parent Program are provided in the member’s home. Discover Hope is under legal obligation to provide a safe and harassment free working environment for all our staff. This includes environments where we provide services to your family, such as your home.
Please ensure your home is free of any hazards.
Please ensure that you interact with our providers in a professional manner.

Managing Challenging and Dangerous Behaviors
Some of the staff of RPP have received training and certification in Safety-Care. Safety-Care provides staff with the skills they need to confidently, safely, humanely, and respectfully enhance the lives of children, adolescents, or adults who sometimes exhibit dangerous or otherwise challenging behaviors. Our staff learn to intervene professionally and therapeutically, using a safe, straightforward, effective approach designed to prevent or reverse escalation.

Our staff are not trained in hands-on restraint procedures and are not able to physically manage children to prevent injury to themselves or others. If a members’ child engages in aggression that requires physical management to keep the child or others safe, Discover Hope requires that the member only be eligible to receive the services in which a responsible adult is always present and able to step in to provide the hands-on intervention.

Confidentiality
Information about your child and family is strictly confidential and will only be released to those agencies and/or persons whom you choose in writing, except for compliance with mandatory reporting requirements.

Discover Hope uses encrypted email. Your child’s information is shared via email with the treatment team and administration only. Although Discover Hope uses encrypted email, please be aware that your email may not be encrypted/secure. Generally, email is not a secure way to transmit confidential information.

Confidentiality of all participants in any group sessions will be covered by additional confidentiality agreement provided to each participant before the first group sessions.

Membership Community Guidelines

The Radiant Parent Program Community is based on these core principles:
No judgement. While mom-shaming is common in our culture and on social media, it has no place in RPP. We believe that every parent is genuinely doing their very best to be the best parent they can be with the tools and resources that they have. Our mission is to provide more tools and resources to parents striving to be better, not to belittle or shame each other.
Be real. This is not a community where you have to pretend like you have it all together. This is a community of people who will be there to support you no matter what! It’s a safe place to be honest and open about your true struggles so you can receive compassion and acceptance from others who are going through the same thing.
Confidentiality. People feel safe to share what’s going on when they know that their secrets are safe. Nothing shared in this community should be shared out in the “real” world. This community is a sacred space and no confidential information learned there should be shared.
Respect. Everyone should be treated with respect at all times. Parenting raises some important and controversial issues, and people may have differing opinions that they are very passionate about. The Radiant Parenting Membership is about providing pros and cons and sharing evidence related to different topics, and allowing each parent to make an informed decision about what is best for their family.
Child safety is a priority. Discussion relating to anything that would physically or mentally harm a child in any way is not a permitted topic.
Focus on similarities. While each member and his/her family will be facing different struggles, and may differ in beliefs, backgrounds, family structure, etc., RPP members will seek out and focus on what they have in common in order to support and build relationships with each other.
The giggles factor. While this program discusses important and sometimes stressful topics, we want to emphasize the fun and joy that can be found in parenting, and to share that with each other. Silliness is encouraged, though never at the expense of others.

Services Offered
Services described may or may not be included in a membership package. Some services will only be available in limited geographic areas. You hereby confirm that you have reviewed and accept the geographic limitations relating to the services offered. You furthermore agree that Discovery Hope has the unilateral right to amend, alter, remove, or modify any of the services offered as a part of RPP.

Book Club:
RPP will select a different book each month to recommend to members. A book club meeting will be scheduled to facilitate discussion about the book. Books are selected based on the amount of value it will offer to parents, and to stimulate conversation about different popular thoughts and teachings about parenting. Discover Hope and RPP does not endorse 100% of the content in any book recommended. Members must obtain their own copy of the book of the month.
Access to our Facebook Community Group
Resource Library:
The Radiant Parenting Program has a growing library of training videos and resources available to its members. The resources here are for members only, and are not to be shared without written consent from Discover Hope.
Behavior Consultation Session:
You will be assigned an individual Behavior Consultant to meet with you and/or family members. The Behavior Consultant is an experienced and highly educated expert in managing behaviors.
In the first month of your membership, you will be required to use credits to purchase your Behavior Consultation Intake Session. In this session, the Behavior Consultant will work with you to create an Individualized Success Plan.
In following sessions, the Behavior Consultant will provide training and support in helping your family work on their plan.
Online Workshop:
Following the monthly webinar, there will be a live online workshop that will guide you through creating or applying ideas from the webinar.
Parent Group:
RPP will facilitate a monthly small group of parents. This group will be topic driven and will allow each parent to share their own experiences and ideas and receive encouragement and support from others.
Social Meetup:
RPP will organize a monthly in-person social meet-up for members to attend with their kids and families. The purpose of this meet-up is to build relationships with other members.
Date Night:
Discover Hope will send a highly trained and experienced staff member to baby-sit your children for up to four hours at a time. Baby-sitting is for your children only. For families with more than 2 children, or with children under the age of 2, there is an additional credit cost.
Staff members are not permitted to bathe children or supervise children near standing water. Staff members are not permitted to transport children or utilize the stove.
Parents should leave meals or food for the staff to warm up and serve.
While baby-sitting, staff members may help with homework, and will play with and engage children in following your normal routine.
The parent must leave emergency contact information. In the event of a medical emergency, the staff member will not be able to transport your child, and will use their best judgement on when to call 911. Discover Hope is not liable for any ambulance or medical fees in the event of an emergency.
Buddy Support:
Schedule appointments for your 18-25 year old child with our compassionate and caring same age “buddies” who will act as a friend and social coach for them while enjoying shared activities.
Staff members are not permitted to transport others, and appointments may not take place near standing water.
The parent must leave emergency contact information. In the event of a medical emergency, the staff member will not be able to transport your child and will use their best judgement on when to call 911. Discover Hope is not liable for any ambulance or medical fees in the event of an emergency.
If you would like the appointment to take place during a paid activity (meals, community activities, parking etc.) then you are responsible for associated costs for your child and the staff member. These costs vary per client and are not included in the membership.
Train Your Helper Online Course:
You will be able to assign other caregivers (baby-sitters, tutors, family members, nannies, etc.) RPP’s online behavior management course to give you peace of mind that they are properly managing your child’s behaviors. This course will consist of 5 modules with quizzes to ensure information is learned. Your caregiver will receive a certificate upon completion.
Email Support:
You will be able to send brief messages to Discover Hope’s Behavior Consultants throughout the month, and should receive a response within 48 hours. If the response is too lengthy or complicated to answer via email, they may advise you to discuss it during a session with your assigned Behavior Consultant.
Friend Pass:
Gift friends and family with 7 days of online access to Radiant Parenting Program Lite.
Disclaimers; No Warranties.
TO THE FULLEST EXTENT PERMITTED BY LAW, THE DISCOVERY HOPE’S SERVICES, INFORMATIONAL CONTENT, WEBSITES AND ALL MATERIALS AND CONTENT AVAILABLE THROUGH DISCOVER HOPE AND/OR THE WEBSITES ARE PROVIDED “AS IS” AND ON AN “AS AVAILABLE” BASIS, WITHOUT WARRANTY OR CONDITION OF ANY KIND, EITHER EXPRESS OR IMPLIED. TO THE FULLEST EXTENT PERMITTED BY LAW, THE DISCOVER HOPE ENTITIES SPECIFICALLY (BUT WITHOUT LIMITATION) DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, RELATING TO THE SITES AND ALL MATERIALS AND CONTENT AVAILABLE THROUGH THE SITES, INCLUDING BUT NOT LIMITED TO (i) ANY IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, QUIET ENJOYMENT, OR NON-INFRINGEMENT; AND (ii) ANY WARRANTIES ARISING OUT OF COURSE OF DEALING, USAGE, OR TRADE. THE ENTITIES DO NOT WARRANT THAT THE SITES OR ANY PART THEREOF, OR ANY MATERIALS OR CONTENT OFFERED THROUGH THE SITES, WILL BE UNINTERRUPTED, SECURE, OR FREE OF ERRORS, VIRUSES, OR OTHER HARMFUL COMPONENTS, AND DO NOT WARRANT THAT ANY OF THE FOREGOING WILL BE CORRECTED.

NO ADVICE OR INFORMATION, WHETHER ORAL OR WRITTEN, OBTAINED BY YOU FROM DISCOVER HOPE OR THE SITES OR ANY MATERIALS OR CONTENT AVAILABLE ON OR THROUGH THE SITES WILL CREATE ANY WARRANTY REGARDING ANY OF THE DISCOVER HOPE ENTITIES OR THE SITES THAT IS NOT EXPRESSLY STATED IN THESE TERMS. TO THE FULLEST EXTENT PERMITTED BY LAW, YOU ASSUME ALL RISK FOR ALL DAMAGES THAT MAY RESULT FROM YOUR USE OF OR ACCESS TO THE SITES, YOUR DEALINGS WITH OTHER VISITORS TO AND USERS OF THE SITES, AND ANY MATERIALS OR CONTENT AVAILABLE THROUGH THE SITES. YOU UNDERSTAND AND AGREE THAT YOU USE THE SERVICE AND SITES AND USE, ACCESS, DOWNLOAD, OR OTHERWISE OBTAIN MATERIALS OR CONTENT THROUGH THE SITES AND ANY ASSOCIATED SITES OR SERVICES AT YOUR OWN DISCRETION AND RISK, AND YOU WILL BE SOLELY RESPONSIBLE FOR ANY DAMAGE TO YOUR PROPERTY (INCLUDING YOUR COMPUTER SYSTEM USED IN CONNECTION WITH THE SITES) OR LOSS OF DATA THAT RESULTS FROM THE USE OF THE SITES OR THE DOWNLOAD OR USE OF SUCH MATERIALS OR CONTENT.
Limitation of Liability.
TO THE FULLEST EXTENT PERMITTED BY LAW, IN NO EVENT WILL DISCOVER HOPE ENTITIES BE LIABLE TO YOU FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR PUNITIVE DAMAGES (INCLUDING, WITHOUT LIMITATION, DAMAGES FOR LOSS OF PROFITS, GOODWILL, USE, DATA, OR OTHER INTANGIBLE LOSSES) ARISING OUT OF OR RELATING TO THE SERVICES PROVIDED BY DISCOVER HOPE, YOUR ACCESS TO OR USE OF, OR YOUR INABILITY TO ACCESS OR USE, THE SITES OR ANY MATERIALS OR CONTENT ON THE SITES, WHETHER BASED ON WARRANTY, CONTRACT, TORT (INCLUDING NEGLIGENCE), STATUTE OR ANY OTHER LEGAL THEORY, WHETHER OR NOT THE COMPANY ENTITIES HAVE BEEN INFORMED OF THE POSSIBILITY OF SUCH DAMAGE.

TO THE FULLEST EXTENT PERMITTED BY LAW, YOU AGREE THAT THE AGGREGATE LIABILITY OF DISCOVER HOPE TO YOU FOR ANY AND ALL CLAIMS ARISING OUT OF RELATING TO THE SERVICES PROVIDED BY DISCOVER HOPE, THE USE OF OR ANY INABILITY TO USE THE SITES (INCLUDING ANY MATERIALS OR CONTENT AVAILABLE THROUGH THE SITES) OR OTHERWISE UNDER THESE TERMS, WHETHER IN CONTRACT, TORT, OR OTHERWISE, IS LIMITED TO AMOUNTS PAID BY YOU TO DISCOVER HOPE FOR THE SIX MONTHS PRIOR TO THE CLAIM ARISING.

EACH PROVISION OF THESE TERMS THAT PROVIDES FOR A LIMITATION OF LIABILITY, DISCLAIMER OF WARRANTIES, OR EXCLUSION OF DAMAGES IS TO ALLOCATE THE RISKS UNDER THESE TERMS BETWEEN THE PARTIES. THIS ALLOCATION IS AN ESSENTIAL ELEMENT OF THE BASIS OF THE BARGAIN BETWEEN THE PARTIES. EACH OF THESE PROVISIONS IS SEVERABLE AND INDEPENDENT OF ALL OTHER PROVISIONS OF THESE TERMS. THE LIMITATIONS IN THIS SECTION WILL APPLY EVEN IF ANY LIMITED REMEDY FAILS OF ITS ESSENTIAL PURPOSE.

Dispute Resolution and Arbitration
Generally. In the event of any controversy or claim arising out of or relating to this agreement, or a breach thereof, the parties shall first attempt to settle the dispute by mediation. If mediation in not successful, and in the interest of resolving disputes in the most expedient and cost-effective manner, you and Discover Hope agree that any and all disputes arising in connection with or in any way related to these Terms or the services or your use of the associated websites will be resolved by binding arbitration. Arbitration is more informal than a lawsuit in court. Arbitration uses a neutral arbitrator instead of a judge or jury, may allow for more limited discovery than in court, and can be subject to very limited review by courts. Arbitrators can award the same damages and relief that a court can award. Our agreement to arbitrate disputes includes, but is not limited to all claims arising out of or relating to any aspect of these Terms or the services or your use of the associated websites, whether based in contract, tort, statute, fraud, misrepresentation or any other legal theory, and regardless of whether the claims arise during or after the termination of these Terms. YOU UNDERSTAND AND AGREE THAT, BY ENTERING INTO THESE TERMS, YOU AND DISCOVER HOPE ARE EACH WAIVING THE RIGHT TO A TRIAL BY JURY OR TO PARTICIPATE IN A CLASS ACTION.
Exceptions. Notwithstanding subsection 13.a, you and Discover Hope both agree that nothing herein will be deemed to waive, preclude, or otherwise limit either of our right to (i) bring an individual action in small claims court, (ii) pursue enforcement actions through applicable federal, state, or local agencies where such actions are available, (iii) seek injunctive relief in a court of law, or (iv) to file suit in a court of law to address intellectual property infringement claims.
Arbitration. Any arbitration pursuant to these Terms will be governed by the Commercial Dispute Resolution Procedures and the Supplementary Procedures for Consumer Related Disputes (collectively, “AAA Rules”) of the American Arbitration Association (“AAA”), as modified by these Terms, and will be administered by the AAA. The AAA Rules and filing forms are available online at www.adr.org, by calling the AAA at 1-800-778-7879, or by contacting Company.
Notice; Process. A party who intends to seek arbitration must first send a written notice of the dispute to the other, by certified mail or Federal Express (signature required), or in the event that we do not have a physical address on file for you, and cannot obtain one, by electronic mail (“Notice”). Company’s address for Notice is: 39210 State Street, Suite 220, Fremont, CA 94538. The Notice must (i) describe the nature and basis of the claim or dispute; and (ii) set forth the specific relief sought (“Demand”). You and Discover Hope agree to use good faith efforts to resolve the claim directly, but if you and Discover Hope do not reach an agreement to do so within 30 days after the Notice is received, you or Discover Hope may commence an arbitration proceeding. During the arbitration, the amount of any settlement offer made by you or Discover Hope will not be disclosed to the arbitrator until after the arbitrator makes a final decision and award, if any.
Fees. In the event that you commence arbitration in accordance with these Terms, Discover Hope will reimburse you for your payment of the filing fee, unless your claim is for greater than $10,000, in which case the payment of any fees shall be decided by the AAA Rules. Any arbitration hearings will take place at a location to be agreed upon in Alameda County, California, provided that if the claim is for $10,000 or less, you may choose whether the arbitration will be conducted (i) solely on the basis of documents submitted to the arbitrator; or (ii) through a non-appearance based telephonic hearing; or (iii) by an in-person hearing as established by the AAA Rules in Alameda County, California. If the arbitrator finds that either the substance of your claim or the relief sought in the Demand is frivolous or brought for an improper purpose (as measured by the standards set forth in Federal Rule of Civil Procedure 11(b)), then the payment of all fees will be governed by the AAA Rules. In such case, you agree to reimburse Discover Hope for all monies previously disbursed by it that are otherwise your obligation to pay under the AAA Rules. Regardless of the manner in which the arbitration is conducted, the arbitrator shall issue a reasoned written decision sufficient to explain the essential findings and conclusions on which the decision and award, if any, are based. The arbitrator may make rulings and resolve disputes as to the payment and reimbursement of fees or expenses at any time during the proceeding and upon request from either party made within 14 days of the arbitrator’s ruling on the merits.
No Class Actions. YOU AND DISCOVER HOPE AGREE THAT EACH MAY BRING CLAIMS AGAINST THE OTHER ONLY IN YOUR OR ITS INDIVIDUAL CAPACITY AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING. Further, unless both you and Discover Hope agree otherwise, the arbitrator may not consolidate more than one person’s claims, and may not otherwise preside over any form of a representative or class proceeding.

Miscellaneous
Severability. The provisions of these Terms are severable. If any provision or term of these Terms is held by a court of competent jurisdiction to be invalid, unenforceable, illegal, or void, such invalidity, unenforceability, illegality, or voidability shall not affect any other term or provisions of these Terms.
Survival. Section 8 (Confidentiality), Section 11 (Disclaimers; No Warranties), Section 12 (Limitation of Liability), and Section 13 (Arbitration) hereof, shall survive termination or expiration of the Agreement for any reason and shall remain in full force and effect.
Electronic Signature. These Terms may be executed electronically, via click through acceptance of these terms. An original signature, or a faxed or emailed copy of a signature to these Terms may be provided to Discovery Hope.
Headings. Section headings are for convenience of reference only and shall not affect the interpretation of these Terms and are not intended for any other purpose whatsoever, or to explain, modify or place any constructions upon or on any of the provisions.
Entire Agreement. These Terms constitute the entire agreement and understanding between the parties relating to the object and scope of the services and products provided by Discover Hope pursuant to these Terms, and supersedes all prior and contemporaneous understandings, agreements, representation, and warranties, both written and oral, regarding such subject matter. Any representation, statement, or warranty not expressly contained in this Agreement shall not be enforceable by the parties.

I hereby acknowledge receipt of Discover Hope’s Radiant Parent Program Agreement. I understand that it is my responsibility to read and know its contents. I hereby represent and warrant that I have read, understand, and agree to all of the above.

First and Last Name: __________________________________ Date: _______________

Signature: ___________________________________________

 

Member’s Informed Consent and Confidentiality Agreement

Confidentiality Agreement: Discover Hope Behavioral Solutions, Inc.’s (“Discover Hope”) members, as more fully described in Radiant Parent Membership Program Terms and Conditions, will have the right to confidentiality by the counseling staff, interns, volunteer leaders, and other employees (collectively referred to as “Staff”) of Discover Hope. While Discover Hope urges members to respect any and all confidential information shared by other group members, Discover Hope shall not be held responsible for any dissemination of confidential information by other group members.
Informed Consent: Discover Hope follows the legal, ethical, and professional standards related to confidentiality. In the following situations, however, Discover Hope facilitators are legally obligated to contact the authorities:
If a group member becomes a danger to himself/herself or another person
If knowledge is attained regarding abuse/neglect of a minor
Responding to a legal issue such as a court subpoena or other legal matter
As a member of Discover Hope, I agree not to share personal information (including names, telephone number, and/or home address) of any group member and/or disclose confidential details of any discussions had during group activities, including but not limited to, book clubs, behavior consultation sessions, online workshops, parent groups, and social meetups, facilitated by Discover Hope. This duty of confidentiality shall remain even after the completion of such activities and after the termination of membership. Additionally, members agree to respect the Staff and to cooperate with other members during group activities facilitated by Discover Hope.
By signing below, member agrees to have read and understood the Discover Hope Member Informed Consent and Confidentiality Agreement.

Group Member Name: _____________________
Group Member Signature: _____________________ Date: _____________________