Please read each statement carefully and sign below before joining your first session.
This form is issued by REENTRY RECOVERY BEYOND, L.L.C. ('Re-Entry, Recovery & Beyond LLC').
If you have one — leave blank if not.
I voluntarily choose to participate in RR&B support group sessions. I understand I may stop attending at any time, and it will not affect my access to other RR&B services.*
I understand that participants are expected to respect one another's privacy, but RR&B cannot guarantee that another participant will keep information shared in the group confidential.*
I understand that Maryland law requires reporting when there is reason to believe a child has been abused or neglected. RR&B facilitators will make required reports to the appropriate authorities. If someone appears to be in imminent danger, the facilitator will take reasonable steps to protect safety, which may include contacting 911 or an appropriate crisis resource.*
I understand that if a crisis or emergency occurs during a session, the facilitator will take reasonable steps to keep everyone safe, which may include contacting emergency services (911) or a crisis resource.*
I consent to RR&B contacting me about group schedules and related services by call, text, or email.