Name *

First Name

Last Name

Group meeting confidentiality disclaimer *

All your communications with Coach (Camil Aponte, PhD, Neuroinclusive Coach at Harmonic Divergence, LLC), will be treated by Coach as confidential, unless you give Coach express permission to disclose specific information. Participants of the group meetings agree to respect the confidentiality of other participants and to not divulge any sensitive/private information shared during the meeting(s). That being said, participants understand and acknowledge that group meetings may involve the sharing of information with others. As Coach cannot control the actions of other participants, Coach cannot guarantee that information shared in any group meeting will be treated as confidential by all participants in attendance. Accordingly, Client hereby agrees to release and hold Coach harmless from any claims, losses, injuries, damages, and expenses of any kind that may result from the disclosure of information shared by Client during any group meeting(s) by any participants.

I agree