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Online Mindfulness Based Stress Reduction (MBSR) Program Agreements and Liability Release

​As a condition of my enrolment in this May 1 to June 26, 2024, Online Mindfulness Based Stress Reduction (MBSR) program, I agree to the following:

  • ​In order to ensure confidentiality of personal and clinical information, I will refrain from audio/video recording as it is not allowed. I will also treat matters that occur within the sessions with the utmost confidentiality. This applies to the names and identities of other participants, as well as all matters discussed by others.
  • To participate in this program, I am required to turn on my Zoom Video/Camera, and keep it on during the session. This allows us to connect and create a sense of community. Options for stepping away from the Video/Camera will also be provided.
  • ​Regular attendance is important for program cohesiveness. I am expected to attend every session, arriving on time, and staying for the entire duration of the session. In the case that I know in advance that I will not be attending a session, I will email Dr. Kasim Al-Mashat accordingly.
  • I understand that there are daily practices and homework that I am expected to engage in between sessions. This will include different mind-body practices such as meditation, and mindful movement. I am aware that audios and handouts will be provided to support my practice.
  • I will have the opportunity to share my thoughts and feelings about the practices and what I will be learning. Although all participants will be encouraged to interact during the session, I reserve the right to determine for myself what personal information I feel comfortable sharing at any given time. I can always say, for example:  “I would like to pass on this”, or “I don’t feel comfortable talking about that right now.”
  • I will notify Dr. Kasim Al-Mashat in advance if I am considering dropping out of the program. It is important to give myself and the facilitator an opportunity to discuss precipitating factors and challenging issues, and to explore alternative ways of meeting my needs.
  • I agree to notify Dr. Kasim Al-Mashat in the event that significant changes occur in my physical or psychological health.
  • I understand that there are some risks involved in the MBSR program.  Physical injury may occur when engaging in any type of physical activity, such as mindful yoga.  The physical practices will be gentle and the risk is minimal.  In addition, I agree to only do what I feel is appropriate for me at that time.
  • I understand that there might be psychological discomforts that could occur when engaging in mindfulness practices as it encourages people to be present with uncomfortable emotions, thoughts and sensations. Information and guidance will be provided to me on how to work with this discomfort.
  • I understand that I am encouraged to discuss changes in my exercise regimen with my physician or health care professional.
  • I understand that if for any reason I am unable to, or think it is unwise to engage in these practices, either during the weekly sessions or at home, I can discuss alternatives with Dr. Kasim Al-Mashat.

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