Informed Consent for Therapy Template
Collects a client’s acknowledgment of therapy policies, consent to participate, contact preferences, and any questions before starting care. Used by therapists and counseling practices during intake.
When to use it
- Before a new client’s first therapy session
- When a practice updates its fees or cancellation policy
- Before starting remote therapy or changing communication methods
- When documenting a client’s consent to participate
What it asks
- Your full name
- Your email address
- Your phone number
- I have reviewed the confidentiality policy, including its limits, and had an opportunity to ask questions.
- I have reviewed the therapy fees and understand how charges are handled.
- I have reviewed the cancellation policy and understand how it applies to me.
- I have reviewed the communication policy, including expected response times and how to get help in an emergency.
- What is your preferred way for the practice to contact you?
- I consent to participate in therapy with this practice.
- What questions or concerns would you like to discuss before therapy begins?
Why it should be encrypted
The form includes identifying and contact details, therapy consent, and potentially personal concerns. These answers should be available only to the intended practice staff, not SealForm or unauthorized people.
Tips
- Add your practice’s specific confidentiality limits, fees, cancellation terms, and emergency instructions.
- Tell clients who will review their answers and how to reach the practice with urgent concerns.
- Confirm the contact options and expected response times are current before sharing the form.