Reproductive Loss Care Consent Form

Program Policies/Client Considerations:

1. Soundview Pregnancy Services is not a mental health or medical clinic.
2. Reproductive loss services may use a bible study format.
3. Our volunteers have received training in crisis support; however, they do not have degrees in counseling, nor are they licensed by the state.
4. In choosing to participate, you understand that the coaching provided is not a substitute for professional counseling.
5. In choosing to participate, you agree to keep all information shared by fellow participants confidential.
6. In choosing to participate, you understand that in extenuating circumstances, information discussed may be shared with Soundview's clinical staff for additional resources and referrals.
7. In choosing to participate, you acknowledge that your documentation and care may be reviewed by Soundview clinical staff and volunteers involved in Reproductive Loss Care.

By signing below, you attest that you have read, fully understand and agree with the above stated information.