Free Group Therapy Informed Consent Form Template

Navigating the nuances of group therapy can be challenging, especially when it comes to ensuring informed consent. This template is designed to help therapists and facilitators clearly inform clients about the scope and nature of group therapy services, fostering confidence and clarity. With user-friendly formatting that includes essential details, this form enhances transparency, builds trust, and promotes a safe therapeutic environment, while also meeting ethical standards. Easily personalize the template to fit your practice and provide your clients with the information they need. Explore the live template to get started.

When to use this form

When you run a counseling group in private practice, a clinic, or a school, use this form before the first session. It sets clear expectations about confidentiality limits, member responsibilities, risks, benefits, and how information is used. It helps you screen fit, confirm attendance rules, and document consent to record-keeping and emergency contact procedures. For clients in the EU or handling personal data, pair it with a GDPR Consent form to cover data rights. If you deliver sessions online, confirm consent before the first video meeting and note any platform risks. Make your exit process clear as well; documenting how a member can stop participation is easy with a Withdrawal of consent form.

Must Ask Group Therapy Informed Consent Questions

Do you understand the limits of confidentiality in a group setting, including the risk that other members may share information?
This sets realistic privacy expectations and reduces misunderstandings. It supports ethical practice and helps you document that the client heard and accepted these limits.
Do you agree to the group guidelines for attendance, participation, and conduct (for example, no recording and on-time arrival)?
Clear norms improve safety, trust, and the flow of sessions. Getting explicit consent lets you address disruptions fairly and consistently.
May we contact you and your designated emergency person if a safety concern arises, and what is the best way to reach you?
Confirming permission and channels allows swift, appropriate action in crises. It also clarifies when and how you may break confidentiality for safety.
Do you consent to telehealth sessions and to receiving electronic communications when needed?
This documents consent for video, email, or text and notes related privacy risks. You can also reference an Electronic informed consent form for fuller detail.
Are you currently using prescribed psychotropic medication, and do you consent to coordinate care with your prescriber if needed?
Knowing this helps you support safety, side effects, and scheduling that may affect group work. You can document separate authorization with a Psychotropic medication consent form.

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Question		Response
Full name		John Smith
Email address		[email protected]
Phone number		555 555 5555
Age range		65+
Emergency contact full name		John Smith
Emergency contact relationship		This is a test
Emergency contact phone		555 555 5555
Group name or topic		This is a test
How will you attend this group?		Online (video)
Participation is voluntary and you may withdraw at any time without penalty.		1
Please share any accessibility or accommodation needs (optional)		This is a test
I will make a reasonable effort to attend scheduled sessions or notify the facilitator if I cannot attend.		1
I understand the purpose of group therapy and potential benefits.		3
I understand that discussing personal topics may cause discomfort or emotional distress.		2
I agree to keep other members' identities and disclosures confidential.		3
I understand the limits of confidentiality (e.g., risk of harm, abuse, or as required by law).		1
Do you consent to audio or video recording of sessions?		No
Are you currently working with a mental health provider?		Yes
Please list any current medications or health conditions relevant to your safety or participation (optional)		This is a test
In the past month, have you had thoughts of harming yourself or others?		Prefer not to say
If I am in crisis, I will contact local emergency services or a crisis hotline; the group is not an emergency service.		4
In an urgent situation during group, I consent to the facilitator contacting my emergency contact.		No
I understand how my information will be stored and used for providing group services and protecting privacy.		4
I understand that participation is free of charge.		1
Are you a parent or legal guardian completing this form for a minor participant?		Yes
Parent/guardian full name		John Smith
I have legal authority to consent to the minor's participation.		3
Type your full name as your signature		This is a test
Date		2025-10-15T00:00:00.000Z
Please select your decision regarding participation		I do not consent

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Group Therapy Informed Consent Form Template

Streamline Your Group Therapy Sessions with Clear Informed Consent

When to use this form

Must Ask Group Therapy Informed Consent Questions

More Forms

Unlock hundreds more featuresSave your Form to the DashboardView and Export ResultsUse AI to Create Forms and Analyse Results

Group Therapy Informed Consent Form Template

Streamline Your Group Therapy Sessions with Clear Informed Consent

When to use this form

Must Ask Group Therapy Informed Consent Questions

More Forms

Unlock hundreds more features
Save your Form to the Dashboard
View and Export Results
Use AI to Create Forms and Analyse Results