Free Psychology Informed Consent Form Template

Obtaining informed consent can be challenging, especially in the nuanced field of psychology. This template is designed for psychologists, researchers, and mental health practitioners seeking to ensure that clients fully understand their rights and the nature of the study or treatment. By using this form, you can facilitate a transparent consent process, enhance compliance, protect your practice legally, and build trust with your clients. Plus, it is WCAG-aligned to meet accessibility standards. Explore this easy-to-use template to streamline your informed consent process.

When to use this form

Use this consent form before you start any psychological service, such as an intake, assessment, or therapy session. It works for solo practitioners, group practices, school clinics, and telehealth. Set clear expectations about goals, methods, privacy, fees, and how to reach you in a crisis. For ongoing counseling, pair it with the Psychotherapy informed consent form to cover routine session terms. If you collect personal data or serve clients in the EU or UK, add a GDPR Consent form for transparent data handling. The result: informed clients, fewer disputes, and documented consent that protects both you and the people you serve.

Must Ask Psychology Informed Consent Questions

Do you understand the purpose of services and what they include (assessment, therapy, referrals)?
This confirms that clients know what will happen and why. It sets shared expectations so you can align the plan of care with their goals.
Do you understand the potential benefits, risks, and reasonable alternatives, and do you agree to proceed voluntarily?
This documents informed choice and the right to withdraw at any time. It reduces misunderstandings and builds trust from the start.
Do you agree to the confidentiality terms and their legal limits, and how your information may be used, stored, and shared?
Stating privacy rules and exceptions (risk of harm, abuse, court orders) prevents surprises. It also clarifies how records, messages, and reports are handled.
Do you consent to any specific procedures that may occur (testing, exposure tasks, audio or video recording)?
Targeted permission avoids confusion when an activity goes beyond a standard session. If needed, attach a Procedure consent form for those discrete steps.
Do you acknowledge the fees, billing process, insurance information sharing, and the cancellation or no-show policy?
Clear money and scheduling terms prevent disputes and missed appointments. It helps clients make informed decisions about affordability and attendance.

More Forms

Question		Response
Client full name		John Smith
Date of birth		2025-10-15T00:00:00.000Z
Email address		[email protected]
Mobile phone number		555 555 5555
Emergency contact full name		This is a test
Emergency contact phone number		555 555 5555
Emergency contact relationship to you		This is a test
I consent to participate in psychological services		Yes
I understand potential benefits and risks of therapy		1
I understand that results are not guaranteed		2
I may withdraw consent at any time without penalty		4
I understand confidentiality and its legal limits (risk of harm, abuse reporting, court order)		1
I acknowledge receipt or availability of the Notice of Privacy Practices		No
I authorize the provider to share relevant information for coordination of care with treating providers		No
I consent to receive appointment reminders		No
You may leave messages about scheduling on my phone or email		Yes
I consent to receive services via telehealth when appropriate		Yes
I will ensure I am in a private, safe location during telehealth sessions		2
I understand that I am financially responsible for fees not covered by insurance		3
I understand the cancellation and no-show policy		4
I consent to audio or video recording of sessions for supervision or training		No
Client typed signature		This is a test
Date signed		2025-10-15T00:00:00.000Z
If signing as parent or legal guardian, print your name		This is a test
Relationship to client (if applicable)		This is a test
I have read this consent form, had the opportunity to ask questions, and agree to the above policies		2

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Psychology Informed Consent Form Template

Streamline Your Research with a Comprehensive Consent Form

When to use this form

Must Ask Psychology Informed Consent Questions

More Forms

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

Psychology Informed Consent Form Template

Streamline Your Research with a Comprehensive Consent Form

When to use this form

Must Ask Psychology 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