One Circle Registration Spring 2026
  • One Circle Registration Spring 2026

  • Thank you for joining us for One Circle!

    Unless otherwise indicated, groups are held once per week, run for 10 weeks, and meet at school during lunch.

  • Don't see a group happening at your school or for a specific age?  Complete our interest form to let us know.  https://form.jotform.com/losalamosjjabinfo/one-circle-interest-form Groups are formed in collaboration with LAPS schools and based on need/requests.

  • Participant Information

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  • Parental Contact Information

  • Format: (000) 000-0000.
  • Los Alamos JJAB Privacy Policy

  • This notice describes how personal/private information (PPI) about you may be used and disclosed and how you can get access to this information. Please review it carefully.

    JJAB will abide by New Mexico state laws as well as federal HIPAA policies. This Notice of Privacy Practices describes how your protected health information may be used and disclosed to carry out operations within our programs and/or therapy treatment for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information.

    Your Rights
    When it comes to your personal information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

    Get an electronic or paper copy of your information

    • You can ask to see or get a copy of your Case Management or Therapeutic file and other personal information we have about you.
    • We will provide a copy or a summary of your personal information, usually within 30 days of your written request.

    Ask us to correct your information

    • You can ask us to correct personal information about you that you think is incorrect or incomplete.

    Request confidential communications

    • You can ask us to contact you in a specific way (for example, home or office phone). We will say “yes” to all reasonable requests.

    Ask us to limit what we use or share

    • All information will remain confidential except in the following circumstances: danger of one acting on suicidal or homicidal thoughts, suspected child or vulnerable adult abuse or neglect, or court order or valid subpoena.
    • You can ask us not to use or share certain personal information for our referral services, therapeutic program, or our operations.
    • JJAB is required to share aggregate information with organizations, grantors, and contractors that provide funding for our programs. 

    Choose someone to act for you

    • If you have given someone power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your service referral.
    • We will make sure the person has this authority and can act for you before we take any action.

    File a complaint if you feel your rights are violated

    • If you feel your rights have been violated, you can make a complaint by contacting us directly at (505) 709-8125 or info@losalamosjjab.com.
    • You may file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/.
    • We will not retaliate against you for filing a complaint.

    Your Choices
    You have a right and a choice regarding the sharing of any of your information.  For certain information, you can tell us your choices about what we may share. If you have a clear preference for how we share your information in the situations described below, talk to us.

    Sharing Information

    For JJAB to share any information with any person or organization, except in the circumstances defined above, you must sign a Consent of Services and/or a Release of Information. 

    • A Release of Information is a document signed by you, where you explicitly state with whom we can share case related information about you.  This may allow us to share information with your family, close friends, your school, or others involved in your care.

    Our Uses and Disclosures
    How do we typically use or share your personal information?

    Referral Services

    We can use your personal information and share it with other professionals for referral purposes. Example: A Resource Specialist may refer you to a medical provider if you identify a need for services.

    Run our organization

    We can use and share your personal information to improve your care and contact you when necessary.

    • The organization is the owner of all official JJAB documents which are kept confidential as directed by privacy rules.

    Obtain funding for the programs used to aid and support you

    With your permission, JJAB may share your information with Los Alamos County, the administrative grant unit of the New Mexico Children, Youth, and Families Department (CYFD), and/or other government agencies to provide funding to our programs.

    • This information can include the youth’s full name, full address, date of birth, gender, ethnicity, race, and tribal affiliation. 

    JJAB shares de-identified information with other organizations/grantors that provide funding for our programs.

    • This can include aggregate information by age, gender, ethnicity, race, tribal affiliation and/or zip code/city of residence.
    • We may release your health information to funding and government agencies authorized to conduct audits, investigations, and inspections of our facilities and services.

    Safety issues

    • We can share personal information about you under certain situations such as:
    • Reporting suspected abuse or neglect.
    • Preventing or reducing a serious threat to health or safety.
    • To a family member, relative, or close personal friend who is involved in your treatment. We may also disclose your health information to help notify or locate a family member or other person responsible for your care.

    Do research or for program development

    We can use or share de-identified information for program development. Example: JJAB may report compiled data such as - 24 Youth expressed a need for walk-in mental health services. 

    Comply with the law

    We will share information about you if state or federal laws require this.  It may include, but not be limited to:

    Sharing information with the Department of Health and Human Services in order for the agency to verify that we are compliant with federal privacy law.

    • For law enforcement purposes or with a law enforcement official.
    • With oversight agencies for activities authorized by law.

    Respond to lawsuits and legal actions

    We can share information about you in response to a court order or valid subpoena.

    Our Responsibilities

    • We are required by law to maintain the privacy and security of your protected personal information.
    • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
    • We must follow the duties and privacy practices described in this notice and give you a copy of the Privacy Policy. We will not use or share your information other than as described here unless we inform you in writing. If you give us permission to share your information, this permission may be revoked at any time.  This revocation must be put in writing and provided to JJAB. 

    The Effective date on this Notice or Privacy Practices is 10/01/2025. We may change our privacy practices from time to time. We may make the changed notice effective for health information we already have. If we change the notice, we will provide you with the revised notice.

  • Consent and Waiver

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  • I understand that the One Circle program requires a weekly commitment and that all program costs are covered by the Los Alamos JJAB. I understand that I may contact the JJAB facilitator associated with my child's group with questions or comments about the Boys Council/Girls Circle/Group. I understand that One Circle encourages creative and verbal expression and that the council/circle guidelines provide the foundation for circle communication.

    For the purpose of effective program facilitation, I authorize the mutual exchange of information regarding my child’s participation in One Circle between the JJAB One Circle Facilitator, JJAB One Circle Coordinator, myself as the parent/guardian of the undersigned child, and if applicable the site school’s counselor.

    All information will remain confidential per the JJAB Privacy Practices, unless I have authorized its exchange, except in the following circumstances: danger of one action on suicidal or homicidal thoughts, danger or injury to oneself or authors, suspected child or vulnerable adult abuse or neglect, or court subpoena. I have received the Notice of JJAB Privacy Practices.

  • I hereby authorize the Los Alamos JJAB to publish the photographs taken of myself and/or the undersigned minor children, for use in JJAB's printed publications, website, and social media for the purpose of promoting their programs.  I acknowledge that since participation in publications, websites, and social media produced by JJAB is voluntary, neither the minor children nor I will receive financial compensation. I further agree that participation in any publication, website, or social media produced by JJAB confers no rights of ownership whatsoever. 

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