Support Group Agreement
This group is a support and social group for mothers of children up to 1 year old. Group size is limited due to space and the need to make the group a comfortable space for attendees. You will receive a formal response to your form letting you know if there is space in the group and where the group will be held. Attendance is not required and fees will not be charged regardless of attendance. This group is not psychotherapy and is not reimbursable by insurance.
This group is professionally facilitated by Nicole Bolognini, MSW, LCSW, PMH-C. While this group is not psychotherapy, the facilitator treats each attendee as a client and will protect with confidentiality of the group members. Should the facilitator encounter the group member outside of group, the facilitator will not acknowledge the group member unless first acknowledged by the group member This is done to protect the confidentiality of the group member.
Space is limited and determination for appropriateness to group is based upon the facilitator's assessment. A brief phone or e-mail consultation will be held with each participant prior to the initiation of group at no cost to the attendee.
The group member may choose to stop attending group at any time. As a courtesy, the facilitator requests that group members notify the facilitator when unable to attend a group meeting and/or no longer planning out attend group meetings.
