This form is CONFIDENTIAL and information is only provided to the Facilitators.
I understand that my participation in this program is entirely voluntary and I am free to withdraw at any time. At the present time, I am planning to participate in the entire program (including the 3-hour retreat), and to practice mindful self-compassion at least 30 min/day (formally or informally). I also understand that I am responsible for my personal safety and wellbeing and will practice self-care throughout the program.