Class Forms



There are three forms that are essential tools you need for your group. Tools for privacy, confidentiality and liability. This is no small matter.

Being a leader brings with it a new level of responsibility in protecting both you, your center and your client. To learn more about privacy policies, let me invite you to view one of the reports from where my research reported about new privacy laws and issues facing nonprofits and online sites.

It is critical that you place a “privacy policy” on your website and it should also be handed out to every recovery client.

Here’s a great way to generate your “privacy policy:”

Just click here to see

This section covers tools like the confidentiality agreement, liability release, and the CLASS CARE PLAN.

Certainly, you should have your own center’s Board or Attorney prepare the actual form for your center. Our downloads are just a sample. It is important to have all three forms available. You may want to print the confidentiality and liability release with a privacy guarantee statement on the front and back of one page.


Confidentiality agreements is an essential tool every support group needs. Whether it is for your personal protection, the protection of your center’s board of directors or if it is to protect the client you are serving, confidentiality agreements are important.

First, Download the sample Confidentiality Agreement.

Use this as a model to write your own agreement specific and unique to your group.

The purpose of the Confidentiality Agreement is to reduce the possibility of future lawsuits from participants. We know that the persons we serve are likely to strike back at us even though we are trying to help them. This agreement establishes a waiver of liability at the beginning of the class. This is one of the first items you should hand out in a live class setting.

In common law jurisdictions, the duty of confidentiality obliges a solicitor to respect the confidentiality of his or her client’s affairs. Information that a solicitor obtains about his or her clients’ affairs may be confidential, and must not be used for the benefit of persons not authorized by the client. Confidentiality is a prerequisite for legal professional privilege to hold.

Ideas for using a confidentiality form:

1. Keep it to one page.
2. Address the content specific to your unique approach to recovery.
3. Be sure to advise your client of what is expected of her and what to expect.

The Confidentiality Form will…

1. Protect your clients privacy
2. Protect you and your center’s personnel
3. Demonstrate to your client that you are professional
4. Provide a formal documentation of your agreement between yourself and your client.
Mutual contracts are used to involve both parties.

Because you are involved in behavioral coaching and encouragement in a restoration session and because this process involves a person’s openly sharing personal, private data with others and with you the leader, that feedback and exposure to private, personal data creates the need for a mutual agreement of confidentiality.

Assignment: Grab the Sample Confidentiality agreement from our DOWNLOADS and print it for your own use. Create your own agreement on your center’s letterhead. Make sure that before any session is started, that you pass out the confidentiality agreement for each individual to sign. Keep these in a safe place, like a support group folder.

It is common to hear a statement in recovery: “What is said here stays here!”

Your role in leading a group must exhibit a focused protection of her privacy at all costs.


Assumption of Risk and Release by Recovery Participant is a faced by every recovery support group. We know that the other side openly claims that we ‘harm’ women by inflicting judgemental guilt upon them for having had the abortion. We also know that ‘plants’ are being sent to centers to purposely catch them in the act. Thus, the liability risk is far to great in today’s litigious culture to not pay attention to the importance of a signed liability release before an individual starts participating in a support group.

Main things you can expect a Liability Release to provide your outreach:

Safety from the risk of potential law suits against your ministry
A legal document if signed by someone over the age of 18 in most states
Demonstrates your clients willingness to allow you to serve her.

Here is a sample Liability form for you to consider. You can print this page and create your own customized liabiliiity release. At Last Harvest, when I lead a support group or weekend retreat, I combine the confidentiality and liability release into a single sheet. they sign one side, flip it over to sign the other. It is then easy to manage because both forms are stored together. DOWNLOAD THE LIABILITY RELEASE



This is a legally-binding Release made by me, ________________________________, (please print your name) to YOUR CENTER’S NAME GOES HERE

I fully recognize that there are dangers and risks to which I may be exposed by participating in (Name and type of activity) during (time period). The following is a description and examples of specific, significant, non-obvious dangers and risks associated with this activity:


I understand that YOUR CENTER does not require me to participate in the recovery course, but I want to do so voluntarily, despite the possible dangers of private issues being discussed openly and risks emotional feelings and trauma I may experience and despite this Release.

I therefore agree to assume and take on myself all of the risks and responsibilities in any way associated with this activity. In consideration of and return for the services, facilities, and other assistance provided to me by YOUR CENTER in this activity, I release YOUR CENTER (and its governing board, employees, and agents) from any and all liability, claims and actions that may arise from injury or harm to me, from my death or from damage to my property in connection with this activity. I understand that this Release covers liability, claims and actions caused entirely or in part by any acts or failures to act of YOUR CENTER (or its governing board, employees, or agents), including but not limited to negligence, mistake, or failure to supervise by the support group.


Confidentiality agreements, sometimes called secrecy or non-disclosure agreements, are contracts entered into by two or more parties in which some or all of the parties agree that certain types of information that pass from one party to the other or that are created by one of the parties will remain confidential. Such agreements are often used when a company or individual has a secret process or a new product that it wants another company to evaluate as a precursor to a comprehensive licensing agreement. Or, perhaps one party wants to evaluate another’s existing commercial product for a new and different application.

Confidentiality agreements perform several functions. First and most obviously, they protect sensitive technical or commercial information from disclosure to others. One or more participants in the agreement may promise to not disclose technical information received from the other party. If the information is revealed to another individual or company, the injured party has cause to claim a breach of contract and can seek injunctive and monetary damages.

Second, the use of confidentiality agreements can prevent the forfeiture of valuable patent rights. Under U.S. law and in other countries as well, the public disclosure of an invention can be deemed as a forfeiture of patent rights in that invention. A properly drafted confidentiality agreement can avoid the undesired‚ and often unintentional forfeiture of valuable patent rights.

Third, confidentiality agreements define exactly what information can and cannot be disclosed. This is usually accomplished by specifically classifying the non-disclosible information as confidential or proprietary. The definition of this term is, of course, subject to negotiation. As one would imagine, the company or individual disclosing the confidential information (the “discloser”) would like the definition to be as all-inclusive as possible; on the other hand, the company receiving the confidential information (the “recipient”) would like to see as narrowly focused a definition as possible.

The type of information that can be included under the umbrella of confidential information is virtually unlimited. Any information that flows between the parties can be considered confidential‚ data, know-how, prototypes, engineering drawings, computer software, test results, tools, systems, and specifications. This list is certainly not exhaustive but does illustrate the breadth of items that can be deemed confidential.

Most confidentiality agreements exclude certain types of information from the definition of confidential information. It is very important that the recipient include these exceptions in the confidentiality agreement. Some commonly employed exceptions are information that the recipient can demonstrate that they had prior to receipt of information from the discloser, information that becomes known to the public through no fault of the recipient, information that becomes known to the recipient from a third party that has a lawful right to disclose the information, information that was public knowledge before the disclosure of the information to the recipient, and information independently created by the recipient.

The confidentiality agreement can also limit each party’s use of the confidential information. For example, the confidentiality agreement can specify that the confidential information is to be used only to evaluate the discloser’s product and cannot be used in the recipient’s business.

An important point that must be covered in any confidentiality agreement is the standard by which the parties will handle the confidential information. Usually, each party will treat the other’s confidential information in the same way that it treats its own. However, this treatment is acceptable only if the recipient has set standards for handling confidential information, such as limiting access to the information or other methods of preserving secrecy.

Therefore, before signing a confidentiality agreement, it would be prudent to investigate the recipient’s practices regarding maintaining secrecy of its own information. If those practices are substandard or even nonexistent, the confidentiality agreement should contain specific provisions concerning limiting access to the confidential information (e.g., clearly marking the information “confidential”).

The agreement must establish a time period during which disclosures will be made and the period during which confidentiality of the information is to be maintained. Some poorly drafted confidentiality agreements will only specify one of these time periods. Furthermore, even if both time periods are specified, it is important to make sure that a starting point is established for the time period during which confidentiality of the information is to be maintained.

If this starting point is not set forth, problems can occur down the road. For example, imagine a confidentiality agreement that specifies that disclosures will be made over a two-year period and that the information must be kept confidential for three years. No starting point is specified for the confidentiality term.

If a company receives the confidential information on the day before the disclosure term ends, does the company have to keep the information confidential for three years from that date or for one year from that date? Obviously, it is to the recipient’s advantage to make the confidentiality time period start with the beginning of the disclosure time period, whereas it is to the discloser’s advantage to make the confidentiality period start with the date of disclosure of the confidential information. The point is that the confidentiality agreement should specifically state the starting date for the confidentiality time period in order to avoid any ambiguity.

Additionally, confidentiality agreements should contain a provision stating that no implied license to the technology or information is to be granted to the recipient and that all tangible embodiments of the information (e.g., models, data, and drawings) should be returned upon request and in no event later than the end of the agreement term, and that no copies shall be retained by the recipient.

In conclusion, there are several situations where a confidentiality agreement is appropriate and may be proposed. Knowing a few basic points concerning confidentiality agreements can ensure that the important purposes they serve will not be defeated by ambiguities or ignorance of the meaning of terms used in the agreement.

I recognize that this Release means I am giving up, among other things, rights to sue the YOUR CENTER , its governing board, employees, and agents for injuries, damages, or losses I may incur. I also understand that this Release binds my heirs, executors, administrators, and assigns, as well as myself.


As facilitator-client confidentiality exists for the benefit of the client, the confidence is the client’s to waive or modify. Hence, the facilitator can reveal confidential information to third-parties where the client allows such an action.
However, consent to allow the disclosure of confidential information does not entitle the facilitator to disclose or use the information for other purposes than those specified by the client.

The authorization does not necessarily have to be explicit. It can be inferred from the terms or nature of the retainer or course payment agreement. The idea that all information imparted within a retainer or course payment agreement is confidential is impracticable.

Often, much of that information is communicated so that it can be disclosed to dispose of a matter, claim, or legal issue. Hence, where information is incidental to the conduct of a retainer or fee paid for the support group, client authorization can be generally taken as given.

Nonetheless, where there is uncertainty, express authority should be sought from the client. This is a form that your center attorney should draft based on your actual needs.

DISCLOSURE Clearly, information that is not confidential does not fall under the duty of confidentiality. Disclosure of information that is already in the public domain does not breach the duty. Further, information that was not in the public knowledge at the time of the retainer agreement, is not subject to the duty if it subsequently enters the public domain. The purpose served by maintaining the confidence – the protection of the client – is arguably extinguished.

Nonetheless, the recovery facilitator still owes a duty of loyalty, and clients may feel betrayed if such information is disclosed, even if it becomes public knowledge. Though there are no legal ramifications for disclosure, discretion on part of the facilitators may be in the long term interests of maintaining the propriety of the recovery support group. CELEBRATE RECOVERY, a popular church-based recovery process based on the 12 steps, says “WHAT IS SAID HERE STAYS HERE!” That is very good advice for any support group team member.



The CLASS CARE PLAN is a form you can copy for each person you are serving. The idea behind this form was to give you a tool to monitor and assess the needs of those you serve.

Access a sample Class Care form in the CLASS CARE FORM

You will likely talk with your participants over the telephone before and during the 10 weeks of the group. You will see and hear things that help you understand her needs. It is important to write these things down. This form allows you to record a number of entries for each person and helps you focus on assessing her need. This is for your eyes only.

A good way to manage the Class Care Plan is to hold a debriefing meeting with your care team after each class session. After the participants leave, while everything is still fresh on your mind, use these pages to record your thoughts and assessments along the way. If she calls you during the week, your Class Care Plan will be a valuable tool. It is a dynamic tool to be used throughout the group. If you need more space to write on, simply attach additional pages of blank paper stapled to this top form.

NEXT: Learn about Scheduling your Restoration group for Men