Informed Consent for Therapy: What Your Form Must Include (With a Checklist)
Short answer: informed consent for therapy is the process of telling a client, in plain language and before you begin, how therapy with you works, what it costs, what the risks and limits are, and when confidentiality can be broken, and then documenting that they agreed. Every major ethics code requires it, and your state board usually adds its own required items, so a good consent form starts from your code and then layers on your board's rules.
I opened my practice on maternity leave, in ten-minute windows, after months of googling how to start. Paperwork like this is hard to google, because the answer depends on your license and state. This guide puts the requirements in one place so you can check your form line by line.
Business education, not legal or clinical advice. This is not legal advice: have an attorney who knows health care law in your state review your forms before you use them. Rules below were checked November 1, 2026.
The short version
- It's a conversation, not just a signature. The ACA code calls for review "in writing and verbally," as "an ongoing part" of therapy.
- The core items are the same across codes. What therapy involves, fees, limits of confidentiality, third parties, risks, the right to ask questions, and the right to stop.
- Your state board adds items. Texas counselors, for example, must list the board's complaint contact and a plan for records if they die or become incapacitated.
- Some things need their own form. A privacy notice, a Good Faith Estimate for self-pay clients, telehealth consent, and recording or AI-notes consent.
- Minors are where states differ most. Check your state's law before you see anyone under 18.
In this guide
- What informed consent for therapy means
- What every therapy informed consent form must include
- What your ethics code requires
- State rules: where your board adds requirements
- The forms that go with informed consent
- Informed consent for minors
- An informed consent checklist you can use
- How to go over consent in the first session
- Frequently asked questions
What informed consent for therapy means
Informed consent means the client understands what they're agreeing to and agrees freely. The AAMFT Code of Ethics puts it in five parts: the client has the capacity to consent, has been adequately informed about the treatment process, has been informed of potential risks and benefits, has consented freely without undue influence, and the consent is documented.
The form is the documentation. The consent itself happens in the conversation. That's why AAMFT says consent happens "prior to initiating services, and as often as necessary throughout treatment." Give the form before the first session, go over it at the start, and revisit it when something changes.
What every therapy informed consent form must include
These items appear across the four major U.S. ethics codes for therapists. Cover all of them, then add your state's rules.
| Item | What to say in plain words | Where it comes from |
|---|---|---|
| How therapy works | Your approach, what sessions look like, goals, and that results can't be promised | APA 10.01(a), ACA A.2.b, NASW 1.03(a), AAMFT 1.2 |
| Risks and benefits | Therapy can help and can also bring up hard feelings | ACA A.2.b, NASW 1.03(a), AAMFT 1.2 |
| Fees and billing | Session fee, length, payment, late-cancel fee, and what happens if a bill goes unpaid | APA 6.04 and 10.01(a), ACA A.2.b |
| Limits of confidentiality | Risk of harm, abuse reporting, court orders, and other legal exceptions | APA 4.02 and 10.01(a), ACA A.2.b, AAMFT 2.1 |
| Third parties | Insurance, supervisors, anyone else involved in care | APA 10.01(a), ACA A.2.b, NASW 1.03(a) |
| Your qualifications | License, credentials, and relevant experience | ACA A.2.b |
| Supervision | If you're pre-licensed: that you're supervised, and your supervisor's name | APA 10.01(c) |
| Records | How records are kept and that clients can ask about them | ACA A.2.b |
| If you die or can't practice | Who takes over records and helps clients transition | ACA A.2.b |
| Technology and contact | How clients reach you, response time, and that email and text aren't secure | ACA A.2.b, NASW 1.03(e) |
| Right to refuse or stop | Clients can say no to any part of treatment or end therapy at any time | ACA A.2.b, NASW 1.03(a) |
| Questions | Clients can ask questions and get answers | APA 10.01(a) |
| Emergencies | You aren't an emergency service; call or text 988, call 911, or go to the nearest ER | Common practice; your board may require an after-hours statement |
| Signatures and date | Client and therapist sign; the client gets a copy | APA 3.10(d), AAMFT 1.2(e) |
Two items are easy to miss. If you'd ever use a collection agency, APA Standard 6.04(e) requires telling the client first and giving them a chance to pay. For court-ordered clients, APA Standard 3.10(c) requires explaining that up front, with the limits of confidentiality.
What your ethics code requires
Your license determines which code you follow.
| Code | Key standard | What it adds |
|---|---|---|
| APA (psychologists), amended effective 2017 | 3.10, 10.01, 4.02 | Inform "as early as is feasible" about therapy, fees, third parties, and confidentiality limits; trainees name their supervisor |
| ACA (counselors), 2014 | A.2.a to A.2.e, H.2.a | Review "in writing and verbally"; the longest list, including care if the counselor dies or is incapacitated |
| NASW (social workers), updated 2021 | 1.03(a) to (i) | Purpose, risks, limits from third-party payers, costs, alternatives, the right to refuse, and the time frame of consent; technology policies; consent before recording |
| AAMFT (marriage and family therapists), revised effective Jan. 1, 2026 | 1.2, 1.11, 2.1, 6.1 | Consent before services and as often as needed; written authorization before recording, transcription, or observation; risks of technology |
State rules: where your board adds requirements
The ethics codes are the floor. Your board, and sometimes your legislature, often lists exact items your consent must contain. Two examples:
- Texas licensed professional counselors must include fees and payment, counseling purposes, goals, and techniques, any license restrictions, limits on confidentiality, any plan for someone else to provide treatment, supervisor details with contact information and qualifications, the board's name, address, and phone number for complaints, and the plan for records if the counselor dies, becomes incapacitated, or closes the practice (22 Tex. Admin. Code 681.35).
- Colorado sets it in statute: a written disclosure covering credentials, client rights, confidentiality and its exceptions, and that records may not be kept beyond seven years, signed no later than the second visit (C.R.S. 12-245-216).
Rules differ by license even within one state: Texas counselors, marriage and family therapists, social workers, and psychologists each have their own rules. Our state rules pages list what each board requires in informed consent, with links to the official rules.
To check your own:
- Open your board's rules (often called "administrative code") and search for "informed consent," "disclosure," and "complaint."
- Search your state's laws for "minor consent" and "mental health records."
- Note the date you checked, and recheck once a year.
The forms that go with informed consent
Informed consent rarely travels alone. Many therapists keep these as separate forms, so each can be signed and updated on its own.
| Form | Who needs it | What the rule says |
|---|---|---|
| Notice of Privacy Practices | HIPAA covered entities: providers who submit HIPAA transactions, like claims, electronically | Give it by the first session, try to get a signed acknowledgment, and post it in your office and on your website (45 CFR 164.520) |
| Good Faith Estimate | Uninsured and self-pay clients | Say estimates are available on your website, in your office, and out loud when scheduling or asked about cost (45 CFR 149.610) |
| Telehealth consent | Anyone offering video or phone sessions | Risks, technology failure plan, response time, emergencies, and verifying identity and location (ACA H.2.a, NASW 1.03(f)) |
| Recording or AI-notes consent | Anyone who records, transcribes, or uses an AI note tool | Written authorization before recording or transcription (AAMFT 1.11); consent before recording (NASW 1.03(h)); some states add more |
Notice of Privacy Practices. It must open with a set header beginning "THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED." If you're private pay and never bill insurance electronically, ask your attorney whether HIPAA applies to you; your state may also have its own privacy law.
Good Faith Estimate. Under the No Surprises Act, the estimate is its own document. Our Good Faith Estimate guide covers timing, contents, and a template.
AI note tools. States have started to regulate this. Under Illinois's Wellness and Oversight for Psychological Resources Act (2025), when AI is used with a recorded or transcribed session, the client must get written notice and give written consent (Public Act 104-0054). Even where your state has no rule, a separate written consent naming the tool, what it does, how long recordings are kept, and the client's right to say no is the safest approach. For the state-by-state details, see AI scribes and AI note consent for therapists.
Informed consent for minors
Who can consent for a minor is set by state law, and the differences are big.
| State | Who can consent to outpatient therapy | Source |
|---|---|---|
| California | A minor 12 or older, if the therapist finds them mature enough to participate intelligently (expanded July 1, 2024); the therapist consults the minor about whether to involve parents | DHCS Behavioral Health Information Notice 24-046 |
| Texas | Generally a parent or guardian; a minor may consent on their own to counseling for suicide prevention, chemical addiction or dependency, or sexual, physical, or emotional abuse | Tex. Fam. Code 32.004 |
Even when a parent consents, the APA code (Standard 3.10(b)) asks you to explain therapy to the young person in terms they understand and seek their assent. If parents are divorced, check the custody order to see who can consent before the first session.
Your minor consent form should say who consented, what parents will and won't be told, and how you handle safety concerns. For couples and families, put your policy on individual secrets in writing; AAMFT Standard 2.1 asks you to explain confidentiality limits to everyone at the start.
An informed consent checklist you can use
Make sure your draft covers each of these:
- You: name, license type and number, state, contact details, and supervisor if you have one.
- Therapy: your approach in plain words, risks and benefits, and no promised results.
- Money: fee, session length, payment, late-cancel fee, and unpaid balances.
- Contact: how to reach you, response time, and that email and text aren't secure.
- Emergencies: you're not an emergency service; 988, 911, or the nearest ER.
- Confidentiality: its limits in a short list, plus insurance and other third parties.
- Records: storage, how long you keep them, access, and your plan if you die or can't practice.
- Ending: how therapy ends, including if a client stops scheduling.
- Rights: to ask questions, refuse any part of treatment, and stop at any time.
- Your board: every required item, including complaint contact, with the date you checked.
- Signatures: client and therapist, dated, with a copy for the client.
How Well Launched helps: Well Launched walks you through opening your practice in order, for your state and license, and most steps take about 10 minutes. One step drafts your starter intake forms with your board's required language: informed consent, a Notice of Privacy Practices, telehealth and AI-notes consent, a release of information, and a Good Faith Estimate. You review every word, rules we couldn't confirm are clearly marked, and it isn't legal advice, so have an attorney review the final versions. The free checklist shows where this step falls for your state.
How to go over consent in the first session
Send the form through your EHR's portal before the first session. The client intake process guide shows where it fits. Then, in the first few minutes:
- Summarize, don't read aloud. Hit the big points: how you work, fees and cancellations, and the limits of confidentiality.
- Name the limits plainly. For example: "What you share stays between us, except if I'm worried about your safety or someone else's, if a child or vulnerable adult is being harmed, or if a court orders me to share."
- Ask what questions they have. APA Standard 10.01(a) calls for "sufficient opportunity" to ask.
- Note it in your record. APA (3.10(d)) and AAMFT (1.2) expect consent to be documented.
- Revisit when things change, such as new fees, telehealth, or a new AI tool.
Frequently asked questions
Does informed consent for therapy have to be in writing?
Usually, yes. The ACA code requires a written and verbal review, and many boards require signed consent. APA Standard 3.10(d) allows oral consent if documented, but a signed form is easiest to prove.
What should a therapy informed consent form include?
At minimum: how therapy works, risks and benefits, fees and billing, limits of confidentiality, third parties, your credentials, records, how to reach you, emergencies, and the right to ask questions and stop. Then add every item your state board requires.
Is a Notice of Privacy Practices the same as informed consent?
No. The Notice of Privacy Practices is a HIPAA document about how health information is used and shared. Informed consent is your agreement with the client about treatment.
Can a minor consent to therapy without a parent?
It depends on the state. In California, a minor 12 or older can consent to outpatient therapy if the therapist finds them mature enough. In Texas, minors can consent on their own only for counseling on suicide prevention, addiction, or abuse. Check your state's law first.
Do I need separate consent to use an AI note-taker?
Yes, in practice. AAMFT requires written authorization before recording or transcription, NASW requires consent before recording, and Illinois requires written notice and consent. A separate signed form is safest.
How often should I update informed consent?
Whenever something important changes, such as fees, telehealth, or new technology, and review it at least once a year. The codes describe consent as ongoing.
Sources
All checked November 1, 2026.
- APA Ethics Code, Standards 3.10, 4.02, 6.04, 10.01
- 2014 ACA Code of Ethics, A.2 and H.2.a
- NASW Code of Ethics, 1.03
- AAMFT Code of Ethics (effective Jan. 1, 2026), 1.2, 1.11, 2.1, 6.1
- 45 CFR 164.520, Notice of privacy practices
- CMS, HIPAA covered entities
- 45 CFR 149.610, Good faith estimates
- CMS, Good faith estimate guide
- 22 Tex. Admin. Code 681.35 (Texas LPCs)
- C.R.S. 12-245-216, Mandatory disclosure
- Texas Family Code 32.004, Consent to counseling
- California DHCS, BHIN 24-046, Minor consent
- Illinois Public Act 104-0054
Ready to get your paperwork in order?
The free checklist walks you through opening your practice in order, including the intake forms your state requires. When you want your forms drafted for your state and license, see the plans.
Related: How to start a private practice as a therapist · The client intake process for therapists · Good Faith Estimate for therapists
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