BCFC - NCMI Hub Guest Confidentiality Agreement This field is hidden when viewing the formGUIDThis field is hidden when viewing the formGUTYPEThis field is hidden when viewing the formreqCodeThis field is hidden when viewing the formuserEmail This field is hidden when viewing the formSubmission Date (Admin Only) MM slash DD slash YYYY The Bilal Newcomer Community Mobilization Initiative (NCMI) Hub is an advisory group that works to coordinate and mobilize services for individuals/families facing barriers within systems. I am attending the Bilal NCMI Hub meeting for the purposes of sharing information on an individual or family I have referred to the project. I understand my roles and responsibilities associated with information sharing as follows: I will only share identifying and relevant information if the participating individual/family has given verbal or written informed consent. I will only share personal and individual/family information relevant to the current situation. I will keep all information heard at the meeting in the strictest of confidence. I understand that all Hub members present at the Hub table are also bound by confidentiality. Guest InformationMy Name(Required)My Agency Name(Required)Hub Meeting date(Required) DD slash MM slash YYYY Guest Signature(Required)Witness informationWitness TitleWitness Name(Required)Witness Signature(Required) Note: The witness should be a member of the Bilal NCMI.
