• POI TOGETHER

  • POI Together is a free, virtual peer-led support group for people diagnosed with premature ovarian insufficiency. To join, please complete this form and confirm that you have read and agree to the participation agreement.

  • Participant Information

  • Do you have a diagnosis of Premature Ovarian Insufficiency?*
  • Which group do you want to join?
  • Group Guidelines

    • Be respectful: Members come from different backgrounds and cope in different ways.
    • Share the floor: Let others speak. The facilitator may guide the conversation so everyone has a turn. You may pass on any topic.
    • No professional advice: Please don't give or ask for medical, legal, or therapeutic advice.
    • Be on Time: Please sign into the meeting at the time for which the meeting is scheduled.  Late attendees may not be allowed to enter the meeting.
    • No promotions: Don't promote or sell products or services.
    • No observers: Professionals, researchers, and students may not attend to observe, and no one may join under false pretenses.
    • Privacy During Groups: Please make sure you sign into the meeting in a quiet and private space.  There are to be no children or other non-group members on camera, or able to listen to the meeting, during online meetings.
    • Removal: Disruptive, disrespectful, or abusive members may be removed.
    • Please contact POI Together with any concerns or questions: Email POITogether@gmail.com.
  • POI Together Participation Agreement

  • POI Together is a free, virtual peer-led support group, open to those with a diagnosis of Premature Ovarian Insufficiency. 

     POI TOGETHER Peer-led Support Groups are not Treatment Services

    • This group is not intended to be, nor take the place of, mental health counseling, psychiatric services, or. medical care.
    • There is no therapist-client or other treatment relationship exists between any group leader and any participant, or between any participants. Some leaders or members may be licensed professionals; When they take part in a group, they do so only as peers, not as therapists, counselors, or advisors, and no therapeutic relationship is formed between them and any other member.

    Non-Discrimination

    • POI Together does not discriminate on the basis of race, religion, national origin, gender, marital status, sexual orientation, disability or any other characteristic protected by state or federal law. 

    POI Together: Assumption of Risk and Liability Release Waiver

    PLEASE READ CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF LIABILITY AND WAIVES YOUR RIGHT TO SUE POI TOGETHER AND THE OTHER RELEASED PARTIES.

    In consideration of the opportunity to participate in a POI Together peer-led support group, I acknowledge and agree to the following:

     Release of Liability and Assumption of Risk

    • On behalf of myself, and anyone claiming on my behalf, I release POI Together Group Leaders and Participants, (collectively, "POI Together"), from all claims, demands, liability, and financial obligations arising from my participation in the Program, including related events, activities, and transportation, whether or not sanctioned by POI Together, and whether occurring before, during, or after the Program.
    • I understand that discussing issues related to Premature Ovarian Insufficiency related issues in a group setting may bring up difficult thoughts and emotions and I am responsible for seeking professional support if I need it.  
    • I understand that participants may discuss their own medical treatment, including but not limited to, hormone replacement therapy, psychiatric treatment, and other medications.  I will not rely on any participants description of their care as a substitute for medical advice or treatment.  I am solely responsible for seeking advice and care from qualified professionals.  
    • I voluntarily pariticipate with knowledge of these risks and assume such risks, whether known or unknown.  
  • Agreement & Signature

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
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