I hereby grant The Boston Ability Center permission to use my likeness in a photograph or video in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of The Boston Ability Center and will not be returned. I hereby irrevocably authorize The Boston Ability Center to edit, alter, copy, exhibit, publish or distribute photos for purposes of publicizing The Boston Ability Center’s programs or for any other lawful purposes. In addition,I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of photographs. I hereby hold harmless and release and forever discharge The Boston Ability Center from all claims, demands, and causes of action which I, my heirs, representatives, administrators, or any other persons acting on my behalf.

I hereby grant The Boston Ability Center permission to use my child’s likeness in a photograph or video in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of The Boston Ability Center and will not be returned. I hereby irrevocably authorize The Boston Ability Center to edit, alter, copy, exhibit, publish or distribute photos or videos for purposes of publicizing The Boston Ability Center’s programs or for any other lawful purposes. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein the likeness of my child appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of photographs or videos. I hereby hold harmless and release and forever discharge The Boston Ability Center from all claims, demands, and causes of action which I, my heirs, representatives, administrators, or any other persons acting on my child’s behalf may take. 

Boston Ability Center, (“BAC”) is committed to protecting the privacy and confidentiality of group participants and their families. In accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and all applicable federal and state regulations, BAC maintains strict policies governing access to and use of Protected Health Information (PHI).

Purpose of HIPAA

HIPAA or Health Information Portability and Accountability Act, is a federal law designed to:

• Protect the privacy and security of patient health information
• Define who is authorized to access Protected Health Information (PHI)
• Establish safeguards to prevent unauthorized disclosure
• Provide patients and families with rights regarding their health information
   

Confidentiality Expectations

While participating in virtual groups through the Boston Ability Center, you may encounter confidential information that is shared by group participants. This may include, but is not limited to:

• Participant names
• Diagnoses
• Demographic and family information
• Observations made during group sessions

ALL INFORMATION SHARED DURING GROUPS IS STRICTLY CONFIDENTIAL. PLEASE RESPECT THE PRIVACY OF ALL GROUP ATTENDEES.

Requirements and Responsibilities

By participating in any capacity at BAC, you agree to:

• Maintain strict confidentiality of all PHI encountered
• Not disclose, discuss, share, copy, or transmit patient information outside of BAC
• Refrain from discussing group participant information with unauthorized individuals, including family and friends
• You may share general experiences for educational purposes only if all identifying information is completely removed and within the purview of your role.

Technology and Electronic Use

As groups will be conducted virtually, strict privacy rules will be in place with regard to the use of electronics. Group participants are in no way permitted to:

• Take photos or screenshots of group sessions/group attendees
• Take audio or video recordings of group sessions
• Share group Zoom links with other individuals
• Invite other non-registered individuals to attend group with them 

BAC staff members are permitted to take photos/videos of group participants who have photo/video consent on file solely for the purpose of sharing via BAC platforms. BAC staff are not permitted to post/share photos/videos outside of the BAC by means other than BAC social media platforms.

Consequences of Non-Compliance

Failure to comply with these confidentiality/privacy policies may result in:

• Immediate termination from group
• Potential civil and/or criminal penalties under federal law
   

Any concerns regarding privacy may be brought to BAC's Privacy Officer:

Janet Crew Wade

The Boston Ability Center

49 Walnut Park, Building #3

Wellesley Hills, MA 02481

(781) 239-0100

 

Acknowledgment and Agreement

By signing below, you acknowledge that:

• You have received and understand this Confidentiality Agreement
• You understand your obligations under HIPAA and BAC policies
• You agree to comply fully with all confidentiality requirements  

Boston Ability Center, (“BAC”) is committed to protecting the privacy and confidentiality of group participants and their families. In accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and all applicable federal and state regulations, BAC maintains strict policies governing access to and use of Protected Health Information (PHI).

Purpose of HIPAA

HIPAA or Health Information Portability and Accountability Act, is a federal law designed to:

• Protect the privacy and security of patient health information
• Define who is authorized to access Protected Health Information (PHI)
• Establish safeguards to prevent unauthorized disclosure
• Provide patients and families with rights regarding their health information
   

Confidentiality Expectations

While participating in virtual groups through the Boston Ability Center, you may encounter confidential information that is shared by group participants. This may include, but is not limited to:

• Participant names
• Diagnoses
• Demographic and family information
• Observations made during group sessions

ALL INFORMATION SHARED DURING GROUPS IS STRICTLY CONFIDENTIAL. PLEASE RESPECT THE PRIVACY OF ALL GROUP ATTENDEES.

Requirements and Responsibilities

By participating in any capacity at BAC, you agree to:

• Maintain strict confidentiality of all PHI encountered
• Not disclose, discuss, share, copy, or transmit patient information outside of BAC
• Refrain from discussing group participant information with unauthorized individuals, including family and friends
• You may share general experiences for educational purposes only if all identifying information is completely removed and within the purview of your role.

Technology and Electronic Use

As groups will be conducted virtually, strict privacy rules will be in place with regard to the use of electronics. Group participants are in no way permitted to:

• Take photos or screenshots of group sessions/group attendees
• Take audio or video recordings of group sessions
• Share group Zoom links with other individuals
• Invite other non-registered individuals to attend group with them 

BAC staff members are permitted to take photos/videos of group participants who have photo/video consent on file solely for the purpose of sharing via BAC platforms. BAC staff are not permitted to post/share photos/videos outside of the BAC by means other than BAC social media platforms.

Consequences of Non-Compliance

Failure to comply with these confidentiality/privacy policies may result in:

• Immediate termination from group
• Potential civil and/or criminal penalties under federal law
   

Any concerns regarding privacy may be brought to BAC's Privacy Officer:

Janet Crew Wade

The Boston Ability Center

49 Walnut Park, Building #3

Wellesley Hills, MA 02481

(781) 239-0100

 

Acknowledgment and Agreement

By signing below, you acknowledge that:

• You have received and understand this Confidentiality Agreement
• You understand your obligations under HIPAA and BAC policies
• You agree to comply fully with all confidentiality requirements  

IMPORTANT NOTE!

All feeding group ticket sales are non-refundable and non-transferable, unless a group leader determines via screening that this group is not an appropriate fit for the participant.