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Informed Consent Form Template for Therapy

Comprehensive informed consent template for mental health practice including telehealth addendum, HIPAA notice, and cancellation policies.

Last updated August 26, 2026

Cover page of the Informed Consent Form Template for Therapy PDF

What's inside

1
Informed Consent for Psychotherapy Services
2
Section 1: Nature of Psychotherapy
3
Section 2: Confidentiality
4
Section 3: Sessions and Fees
5
Section 4: Cancellation Policy
6
Section 5: Emergency Procedures
7
Section 6: Communication and Social Media
8
Section 7: Records and Documentation
9
Section 8: Termination of Treatment
10
Telehealth Addendum
11
Client Consent and Signature
12
HIPAA Notice of Privacy Practices Acknowledgment
13
Quick Customization Checklist

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Frequently Asked Questions

This resource includes Informed Consent for Psychotherapy Services, Section 1: Nature of Psychotherapy, Section 2: Confidentiality, and 10 more sections. Comprehensive informed consent template for mental health practice including telehealth addendum, HIPAA notice, and cancellation policies.

The Informed Consent Form Template for Therapy is designed for behavioral health professionals, including therapists, counselors, clinical directors, and practice administrators. It provides practical tools and frameworks that can be immediately applied in mental health, substance use disorder, and integrated care settings.

Yes, the Informed Consent Form Template for Therapy is completely free. Enter your name, work email, and role, and the download starts immediately. Where a resource also has a print-ready form version, the same details unlock both files.

The Informed Consent Form Template for Therapy is designed to be adapted to your specific practice needs. All templates and frameworks can be modified to match your workflow, documentation requirements, and clinical approach.

Ease Health provides an all-in-one EHR, billing, and CRM platform purpose-built for behavioral health. It brings admissions and referral tracking, clinical documentation, and billing into one system, with AI assistance built into the documentation workflow rather than bolted on. Request a demo at easehealth.com to learn more.