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  • Common Ground Support Group Registration
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  • Statement of Confidentiality

    Because Common Ground Caregiver support groups are a response to individuals or families facing a variety of catastrophic needs, we ask all participants to acknowledge the importance of confidentiality and to maintain confidentiality regarding all who are served through Common Ground. Facilitators do, however, still have a “duty to warn” which means they have the obligation to report suspected abuse. We thank you for confirming our belief in the integrity of this program.

    Given the sensitive and highly personal nature of the relationship between the participants, I acknowledge that confidentiality is essential. I also acknowledge that a participant’s right to privacy shall be respected and that all information obtained in connection with the Common Ground group will remain confidential within the constraints of the law. I also understand that any information regarding those served shall not be disclosed without the person’s written consent, except as may be necessary to provide the requested services.

    By signing below, I agree to participate in Common Ground. Our online support groups are not recorded or made publicly available. Should you choose to participate in our programs that are public events such as educational conferences and workshops or Gathering Place programs, you are giving consent to photographs or videos being taken of you and/or your loved one at those locations. These photographs may be used in print, film, online or social media by CarePartners and our partners without liability of any nature.

     

  • Please type name here:         Date:   Pick a Date   

  • Thank you for registering for our online Common Ground support group facilitated by Erial Green. We are very pleased to welcome you to all programs sponsored by CarePartners and look forward to serving you. For information about all of our programs, please visit our website www.CarePartnersTexas.org or you may call us at 713-682-5995.

    We will follow up with you via email to send the Zoom link that you may use to join your group. 

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