Edu-Well-Being Support pod with Julia

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This is to sign up to join the support group with Julia.

• Creating a community for Teacher Wellness
• Sharing expertise, experiences which enhance our lives and profession
• Supporting you by creating a time for your self-care
• Improve social and emotional development through collaboration

Email *

Name

Surname

Share three words which you would use to describe yourself

What would you like to get out of the group?

Province

School - We ask this question because we highly recommend that two teachers from the same school are not in the same group.

Agreements

To the best of my ability I will:

1. Own my experience, by using “I” to speak.

2. Practice empathy for myself and others.

3. Approach content and discussions with curiosity.

4. Be honest in my communication, within what is appropriate and okay for me to share and communicate.

5. Be respectful towards another person’s perspective, even when their ideas, beliefs, and understanding of a situation differ from my own.

6. Practice loving-kindness, which is defined as showing tenderness and consideration towards self and others.

7. Maintain confidentiality

I agree to the above statements *

Yes

Confidentiality

These groups are confidential and it is very important that we have agreements to create a safe container for everyone involved

As a member of the support group led by Julia, I understand that I may have access to confidential information of participants. By signing this statement, I am indicating my understanding of my responsibilities to maintain confidentiality. *

Yes

I understand that names and any other identifying information about participants are completely confidential. *

Yes

I agree not to divulge, publish, or otherwise make known to unauthorized persons or to the public any information obtained in the course of this support group that could identify the persons who participated in the group *

Yes

I understand that I will keep information which is shared during the group sessions, confidential and will not share it with anyone, on any platform, without the express, written permission of both the participants and Julia Hannah. *

Yes

I agree to notify Julia Hannah or the Explorare team immediately should I become aware of an actual breach of confidentiality or a situation which could potentially result in a breach, whether this be on my part or on the part of another person. *

Yes

A copy of your responses will be emailed to the address you provided.

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