Client Confidentiality Agreement

Meals With A Friend, LLC

Effective Date: 04/28/2025

1. Purpose

Meals With A Friend (MWAF) is committed to protecting the privacy and confidentiality of all client information. This agreement outlines how personal, medical, and sensitive information shared with MWAF will be handled.

To maintain respect and consistency, all participants in the program are referred to as "clients."
Additionally, any outside person (including volunteers, visitors, or affiliates) who becomes aware of client information is legally required to keep that information confidential. No information may be shared with any third party unless authorized by the client or an MWAF staff representative.

2. Confidential Information

For this agreement, "Confidential Information" includes but is not limited to:

  • Personal identifying information (e.g., name, address, phone number, email)
    Medical and dietary needs or restrictions

  • Emergency contacts and personal safety information

  • Any information shared during friendly visits or communications that is of a personal or sensitive nature

3. MWAF's Commitment

Meals With A Friend agrees to:

  • Maintain the confidentiality of all client information, both written and verbal.

  • Limit access to client information to authorized MWAF volunteers and staff who need the information to fulfill their role.

  • Only share information with third parties (e.g., emergency services) when necessary for the client’s safety or required by law.

  • Store client records securely, whether physical or digital.

4. Client's Acknowledgment

I understand and agree that:

  • My information will be used only to deliver services through MWAF (meal deliveries, friendly visits, and related communications).

  • MWAF volunteers and staff are trained to respect and maintain confidentiality.

  • Essential information may be shared with medical professionals or emergency responders in the event of a perceived emergency or safety concern.

  • MWAF is not responsible for any information I voluntarily share with volunteers outside the scope of the program’s services.

5. Exceptions to Confidentiality

Confidentiality may legally be broken if:

  • MWAF staff or volunteers suspect abuse, neglect, or danger to themselves or others, and are required to report it to appropriate authorities.

  • Disclosure is required by law, court order, or regulatory authority.

6. Client Consent

By signing this form:

  • I acknowledge that I have read, understood, and agree to the above confidentiality practices.

  • According to these guidelines, I consent to MWAF’s use and protection of my information.

  • I understand that I can revoke my consent in writing at any time, although prior uses of