{"id":1779,"date":"2025-05-15T16:40:06","date_gmt":"2025-05-15T21:40:06","guid":{"rendered":"https:\/\/staging5.nsd.tech\/?page_id=1779"},"modified":"2025-05-30T11:26:38","modified_gmt":"2025-05-30T16:26:38","slug":"bcfc-ncmi-hub-guest-confidentiality-agreement","status":"publish","type":"page","link":"https:\/\/staging5.nsd.tech\/fr\/bcfc-ncmi-hub-guest-confidentiality-agreement\/","title":{"rendered":"BCFC- NCMI Hub Guest Confidentiality Agreement"},"content":{"rendered":"<div id=\"cs-content\" class=\"cs-content\"><div class=\"x-section e1779-e1 m1df-0\"><div class=\"x-row x-container max width e1779-e2 m1df-1 m1df-2\"><div class=\"x-row-inner\"><div class=\"x-col e1779-e3 m1df-3 NsdSpacerSmallAll\"><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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Confidentiality Agreement<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_408' id='gform_408'  action='\/fr\/wp-json\/wp\/v2\/pages\/1779' data-formid='408' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_408' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_408_23\" class=\"gfield gfield--type-text gfield--width-quarter CLIENT_UNQCODE exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_408_23'>GUID<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_408_23' type='text' value='' class='large'   tabindex='1'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_408_24\" class=\"gfield gfield--type-text gfield--width-quarter ACTOR_TYPE exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_408_24'>GUTYPE<\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_408_24' type='text' value='' class='large'   tabindex='2'   aria-invalid=\"false\"   \/><\/div><\/div><div data-fieldId=\"24\" class=\"spacer gfield\" style=\"grid-column: span 6;\" data-groupId=\"c92b401c\"><\/div><div id=\"field_408_26\" class=\"gfield gfield--type-text gfield--width-quarter REQCODE exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_408_26'>reqCode<\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_408_26' type='text' value='' class='large'   tabindex='3'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_408_25\" class=\"gfield gfield--type-email gfield--width-third EMAIL exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gpev-field\"  data-field-class=\"gpev-field\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_408_25'>userEmail<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_25' id='input_408_25' type='email' value='' class='large' tabindex='4'    aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div data-fieldId=\"25\" class=\"spacer gfield\" style=\"grid-column: span 5;\" data-groupId=\"75b9f809\"><\/div><div id=\"field_408_27\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full START_DATE exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_408_27'>Submission Date (Admin Only)<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_27' id='input_408_27' type='text' value='26\/04\/2026' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon' tabindex='5'  placeholder='mm\/dd\/yyyy' aria-describedby=\"input_408_27_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_408_27_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_408_27' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_408_11\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>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.<\/p>\n\n<p>\n  <strong>I am attending<\/strong> the Bilal NCMI Hub meeting for the purposes of sharing information on an individual or family I have referred to the project.\n<\/p>\n\n<p>I understand my roles and responsibilities associated with information sharing as follows:<\/p>\n<ul style=\"padding-left: 50px; list-style-type: circle;\">\n  <li>I will only share identifying and relevant information if the participating individual\/family has given verbal or written informed consent.<\/li>\n  <li>I will only share personal and individual\/family information relevant to the current situation.<\/li>\n  <li>I will keep all information heard at the meeting in the strictest of confidence.<\/li>\n<\/ul>\n\n<p>I understand that all Hub members present at the Hub table are also bound by confidentiality.<\/p>\n\n\n\n<\/div><div id=\"field_408_20\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Guest Information<\/h3><\/div><div id=\"field_408_7\" class=\"gfield gfield--type-text gfield--width-third F_424 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_408_7'>My Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_408_7' type='text' value='' class='large'   tabindex='6'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_408_14\" class=\"gfield gfield--type-text gfield--width-third F_425 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_408_14'>My Agency Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_408_14' type='text' value='' class='large'   tabindex='7'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_408_21\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-third D_402 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_408_21'>Hub Meeting date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_21' id='input_408_21' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='8'  placeholder='dd\/mm\/yyyy' aria-describedby=\"input_408_21_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_408_21_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_408_21' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_408_3\" class=\"gfield gfield--type-signature gfield--width-third F_429 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_408_3'>Guest Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><input type='hidden' value='' name='input_3' id='input_408_3_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_408_3_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_408_3' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: 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style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_408_3_data' name='input_408_3_data' value=''><\/div><\/div><div data-fieldId=\"3\" class=\"spacer gfield\" style=\"grid-column: span 8;\" data-groupId=\"67230055\"><\/div><div id=\"field_408_19\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Witness information<\/h3><\/div><div id=\"field_408_16\" class=\"gfield gfield--type-text gfield--width-quarter F_426 field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_408_16'>Witness Title<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_408_16' type='text' value='' class='large'   tabindex='9'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_408_12\" class=\"gfield gfield--type-text gfield--width-seven-twelfths F_420 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_408_12'>Witness Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_408_12' type='text' value='' class='large'   tabindex='10'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_408_17\" class=\"gfield gfield--type-signature gfield--width-third F_421 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_408_17'>Witness Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><input type='hidden' value='' name='input_17' id='input_408_17_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_408_17_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_408_17' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_408_17_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_408_17_resetbutton' 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style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_408_17_data' name='input_408_17_data' value=''><\/div><\/div><div data-fieldId=\"17\" class=\"spacer gfield\" style=\"grid-column: span 8;\" data-groupId=\"2b62e1cb\"><\/div><div id=\"field_408_18\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p> Note: The witness should be a member of the Bilal NCMI.<\/p><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_408' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Envoyer' tabindex='11' \/> <input type='hidden' name='gform_ajax' 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