Support Group Registration Form

Thank you for your interest in attending an ANAD Support Group! Each group is completely FREE and 75 minutes in duration. Please complete the following interest form to receive registration emails. Once you opt into a group, look for our email letting you register for some or all groups for the month. Please ONLY register for groups you will attend.

Registration for the next month opens in the last week of the month prior. Please visit this page to register for each month’s groups. Check your spam folder, then email with questions. Thank you!!

This is only in case of emergency. ANAD will not notify your parents of your registration unless an emergency situation arises.

Support Group Attendee Agreement, Liability and Disclaimer

ANAD’s support groups are not group therapy, do not substitute for treatment and shall not take the place of such but offer ongoing support and community for those suffering from eating disorders.

Confidentiality: All members of the group are required to maintain confidentiality of the identity of members and discussions that take place in group. I understand that what is discussed in the group is not to be discussed outside of the group or with others with the exception of members who specifically agree to meet or talk to each other outside of group and limit their discussion to their own issues, not discussing anyone else in the group or what other members have shared. However, there are no laws governing the confidentiality of support groups and my confidentiality cannot be guaranteed. I understand and agree that if ANAD or my group leader determines that I have violated the confidentiality of another group member, I may not be permitted to continue participating in the group.

Group Leader: The support group will be run by an approved individual who has been trained as an ANAD Support Group Leader to run an eating disorder support group. Supervisors may or may not attend groups but are considered members of the group such that the group leader will share information about the group members and the discussions that take place in the group with supervisors if necessary.

Appropriateness for A Support Group: The support group leader will determine appropriateness for individuals becoming a member or remaining a member of the group using their best judgment and possible consultation with the supervisor. If an individual is not appropriate for the support group due to severity of illness, suicidality or other reason(s), it is the duty of the leader to not approve joining or continuing the group and refer the person to other resources or level of care. Suicidal members will be referred immediately and appropriate agencies or persons will be contacted.

Virtual Support Groups: The same confidentiality requirements that apply to in-person support group meetings also apply to virtual support groups. I understand that any video conferencing and other electronic technology used to facilitate virtual support groups may not be secured or encrypted, and that my use thereof presents potential risks including, but not limited to, service interruptions, unauthorized access or interception by third parties outside of the group, and technical difficulties. I further understand that, if I decide to participate in virtual support group meetings, it is my responsibility to do so in an appropriate manner and in an appropriate location in order to prevent individuals outside of the group from participating or receiving inadvertent disclosures of confidential information, including, but not limited to, the identity of group members and discussions that take place in the virtual support group. I further acknowledge and agree that group members are not permitted to record virtual support group meetings, and I will not record virtual support group meetings in any manner. However, I understand the risk that virtual support group meetings may be recorded by other members, notwithstanding ANAD’s policy to the contrary.

Liability and Disclaimer: I agree that my involvement in the ANAD eating disorder support group is a peer lead group and not a replacement for therapy or treatment. I understand that the group leader is not a licensed professional and cannot provide medical or psychological advice. It is my responsibility to use this group as a supplement to any professional care or treatment I might need. I understand that ANAD, the support group leader and other members of the group are not responsible for me or my condition or the decisions I choose to make. I understand and agree that ANAD is able to use de identified data that I provide via surveys and interviews for improvement of services.

Accordingly, in consideration of being allowed to participate in the ANAD eating disorder support groups, I, on my own behalf and on behalf of my heirs, executors and administrators, do hereby forever release from liability and waive my right to sue ANAD and its employees, officers, leaders, volunteers and agents (collectively, “ANAD Personnel”) for any and all claims I may have now or in the future have against any ANAD Personnel in connection with, related to or resulting from my participation in the ANAD eating disorder support groups or any incidental activity, including, but not limited to, any negligent act or omission by any ANAD Personnel.

Confidentiality Agreement

I agree that I will keep confidential the personal information of other group participants taking part in the ANAD support group. “Personal information” refers to information that may be used to determine the identity of another group member such as the name of a group member, the name of other family members, home address, or phone number.

Furthermore, I agree to keep confidential any discussion that takes place in the group. I understand that what is discussed in the group is not to be discussed outside of the group or with others with the exception of members who specifically agree to meet or talk to each other outside of the group and limit their discussion to their own issues, not discussing anyone else in the group or what other members have shared. To that end, in the event that I choose to participate in any virtual support groups, I (a) agree to do so in an appropriate manner and in an appropriate location in order to prevent individuals outside of the group from participating or receiving inadvertent disclosures of personal and other confidential information, (b) acknowledge and agree that the same confidentiality requirements that apply to in-person support group meetings also apply to any virtual support group meetings, and (c) agree not to make any audio, video or other recordings of any support group meetings (or any portion thereof).

I understand that once the group has been terminated, I must continue to abide by the confidentiality agreement. I understand that there are no laws governing the confidentiality of support groups and my confidentiality cannot be guaranteed.

All parties should make reasonable efforts under all circumstances to keep discussions between peer group leaders and peer group participants confidential to the greatest extent possible. While confidentiality cannot be guaranteed, your leader has been trained and screened; and ANAD has deemed them appropriate for facilitating, which includes the leader’s commitment to respect your confidentiality as outlined above. Consistent with this commitment, however, your leader will likely be discussing your progress with their ANAD supervisor as this is a necessary part of their ongoing facilitating responsibilities.

Moreover, notwithstanding the above, if your group leader believes that you or someone else may be in danger, they will report the relevant circumstances to the appropriate parties to ensure the health and safety of all involved. Further, information involving the following circumstances cannot be held confidential by group leaders:

● If it is disclosed that a minor, which is defined as a child who is 17 years of age or younger, has been or is at risk of being physically, sexually, or emotionally injured by another individual;

● If it is disclosed that one of the group members or group leader intends to physically, sexually, or emotionally injure another individual; or

● If it is disclosed that a group member or group leader intends to inflict personal injury on himself or herself.

Sign up to join an ANAD Support Group

Below, please select the group(s) you would like to attend. Once we receive your completed form, you will be contacted with login information for each of your selections. You will receive weekly group reminder emails with the zoom link.

By submitting this form, you are consenting to receive marketing emails from: ANAD, PO Box 409047, Chicago, IL, 60640 United States, http://National Association of Anorexia Nervosa and Associated Disorders. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact.

Groups are free for anyone who needs it, but if you can spare a few dollars, it helps us recruit volunteers, train, and keep our virtual doors open to anyone looking for support. Please give if you can! Even a couple dollars makes a big difference