Professional Counseling Informed Consent Template
Get every new counseling client on the same page about confidentiality, fees, and the therapy process — without printing a single sheet.
A complete informed consent form for licensed counselors, therapists, and clinical social workers. Covers the limits of confidentiality, session structure, fees, cancellation policy, and the client's rights — all signed before the first 50-minute hour begins.
Why use a professional counseling informed consent?
What's included in this template
14 fields — customize any field or add new ones with AI.
Need different fields?
Tell the AI what to change — "add a budget dropdown" or "remove phone number" — and it edits the form instantly. Every field type above can be added, removed, or relabeled through the chat interface.
Key features of this professional counseling informed consent template
Everything you need to launch this form in minutes, share it with your team, and collect submissions reliably.
E-signature with timestamp
Captures a drawn signature plus the exact submission time, so your records meet the documentation standard most boards expect.
Confidentiality-limits checklist
Breaks the mandatory-reporting and duty-to-warn carve-outs into separate checkboxes — clients have to actively acknowledge each one, not just scroll past a wall of text.
Crisis information block
A built-in section for after-hours contact info and the 988 lifeline, so clients always know what to do between sessions.
Optional ID/insurance upload
Clients can attach a photo of their insurance card during intake, cutting one more task from the first visit.
Mobile-first reading flow
Long consent text is broken into short, scannable sections so clients actually read it on a phone instead of scrolling and signing.
Save-as-PDF copy for the client
Once signed, the client receives an emailed copy for their own records — required by some state boards.
Perfect for
How to use this template
Open the template
Click "Use this template free." Flexform loads the form instantly — no account needed to preview.
Customize with AI
Type what you want to change in the chat: fields to add or remove, rename labels, change field types, or rearrange pages.
Connect & publish
Link to Google Sheets or Slack with one click, then embed on your site or share the link.
Ways to use this template
Solo private practice intake
A new client books a first session through your website. The booking confirmation includes the consent link — they sign it the day before, and you walk into session knowing they've read the cancellation policy and confidentiality limits.
Telehealth-only practice
Add a telehealth-specific disclosure section (recording policy, what to do if the connection drops, which state's laws apply) and email the link as part of your pre-session checklist. Works equally well for Doxy.me, Zoom for Healthcare, or SimplePractice users.
Group practice central intake
One consent form, routed by clinician. The submission lands in a shared Google Sheet that your intake coordinator uses to assign the client to the right therapist's caseload.
School or college counseling center
Counselors meeting with students 18 and over can use this as the standalone consent; for minors, pair it with a separate parent/guardian consent form linked from the same page.
Pastoral counseling
Faith-based counselors who are not licensed clinicians can adapt the language to make the scope of their work explicit — including when they'll refer out to a licensed professional.
EAP and short-term contract counseling
For 6-session EAP engagements, customize the fee and duration paragraphs to reflect the employer-sponsored arrangement instead of a self-pay schedule.
Workflow integrations
Connect this form to your existing tools with no middleware. Every submission triggers your workflow automatically.
Real-time sync
Data appears in your CRM or spreadsheet within 1–2 seconds of submission — no cron jobs, no delays.
Conditional routing
Route submissions to different Slack channels, HubSpot pipelines, or Airtable bases based on field values.
Two-way data flow
Pre-fill form fields with CRM data for returning visitors. Update existing records instead of creating duplicates.
Why choose Flexform?
Frequently asked questions
Is an electronically signed consent form legally valid?
In every US state and under the federal ESIGN Act, a typed or drawn electronic signature has the same legal weight as a wet signature for most clinical documents — including informed consent. Your state licensing board may have additional documentation requirements, so check those, but the signature itself is recognized.
Is FlexForm HIPAA compliant?
FlexForm offers a Business Associate Agreement (BAA) on paid plans, which is what HIPAA requires when a vendor handles PHI on your behalf. For practices that need to meet HIPAA, you'll want to be on a plan that includes the BAA before collecting client information through the form.
Can I add a telehealth-specific disclosure?
Yes — describe what you need in the AI editor ("add a telehealth section covering recording policy, technical disruption, and state-of-residence requirements") and it will be inserted as new paragraphs with their own acknowledgement checkboxes. No template rebuild required.
What happens to the signed form after the client submits it?
You get a notification (email, Slack, or webhook — your choice), the response is stored in your FlexForm dashboard, and the data can be pushed to Google Sheets if you keep a master client log there. The client also receives an emailed copy of what they signed.
Can clients sign on their phone?
That's the most common way clients actually fill it out. The signature pad works with finger or stylus on iOS and Android, and the layout is built for mobile-first reading so the consent language doesn't get squeezed.
Do I need a separate form for minors?
Yes — informed consent for a minor is technically given by the parent or guardian, with the minor providing assent. Use this template for adults, and duplicate it to create a parent/guardian consent version with assent language for clients under 18.
Can I embed this form inside my practice's mobile app?
You can — our Kotlin Multiplatform SDK lets you embed any FlexForm inside a native Android and iOS app from one codebase. Group practices that have already shipped a client portal use this to keep the consent flow inside their existing app instead of bouncing clients to a web link.
How do I keep the signed consent for the required retention period?
Most state boards require records to be kept for 5–7 years after the last contact (longer for minors). Export submissions to Google Sheets or your EHR for long-term storage, and keep the original record in your FlexForm dashboard as the audit-trail copy.
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