Informed Consents to Provide to Clients

6
min read

As a mental healthcare provider, you are subject to consent and/or disclosure laws. These requirements vary by state and profession, and can range in complexity. This article reviews the various rules and regulations applicable to providers in the SonderMind network.

Some of the requirements identified below are covered in the documents every new SonderMind client agrees to or acknowledges when they create their SonderMind account (i.e. our Terms of Service, Privacy Policy, and Notice of Privacy Practices.) However, the remaining items should be disclosed to and discussed with every new client prior to the start of treatment. In addition, we recommend obtaining written authorization from a client prior to releasing their protected health information (PHI) with providers outside of SonderMind’s network.

** Please note that regulations and policies change overtime, so you should speak to your local licensing board and legal counsel for up-to-date information.

Arizona

Colorado

D.C. (District of Columbia)

Georgia

Indiana

Kentucky

Maryland

Missouri

Nebraska

Ohio

Texas

Virgina

Arizona

Age of Consent

In Arizona, a client must be at least 18 years old to consent to therapy. If the client is underage, the written or oral consent of a parent or a legal guardian is required except in emergency circumstances.


Informed Consent to Treatment (required)

Counselors, Marriage & Family Therapists, Social Workers

Arizona’s Board of Behavioral Health Examiners requires a dated and signed informed consent document covering the following important items:

  • The purpose of the recommended treatment, and what are the associated risks and benefits.
  • The client’s right to access their own medical records, as well as the method to obtain records Note that this information is already covered in SonderMind’s Notice of Privacy Practices.
  • The provider’s obligations related to confidentiality, as well as the limitations thereof. 
  • If you are being supervised or are practicing in collaboration with a team, you must notify the client.
  • The client’s right to participate in treatment decisions, as well as their right to refuse treatment or withdraw their consent and any associated consequences.

Psychologists

Arizona’s Board of Psychologist Examiners adopted the American Psychological Association’s Ethical  Principles of Psychologists and Code of Conduct and requires a dated and signed informed consent document covering the following important items:

  • The nature of the treatment, the potential risks involved, alternative treatments, and the voluntary nature of their participation.
  • Involvement of third parties.
  • The provider’s obligations related to confidentiality, as well as the limitations thereof. 
  • The client must be notified of available alternatives, the voluntary nature of their participation in treatment with an opportunity to ask questions and receive answers.
  • If the therapist is a trainee, the client must be informed that the therapist is in training and is being supervised with the name of the supervisor.


Teletherapy Consent Form (required)

Counselors, Marriage & Family Therapists, Social Workers

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • The limitations and risks in telepractice including confidentiality risks, and potential technology failures leading to the provider and client being disconnected. The provider and client should discuss an emergency procedure for these situations, and verify that they have up-to-date emergency contact information.
  • The provider will maintain a client record for any teletherapy session just like they would if the therapy session had occurred in person.


Psychologists

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • How the provider will verify the identity of the client if not using video.
  • How the provider will ensure the client’s electronic communications are received only by the provider.
  • When and how the provider will respond to routine electronic communications.
  • The circumstances under which the provider and the client will use an alternative means of communication.
  • Who is authorized to access the electronic communication.
  • The manner in which the provider stores the electronic communication.
  • The type of secure electronic technology the provider will use to communicate with the client.
  • The limitations and risks in telepractice including confidentiality risks, and potential technology failures leading to the provider and client being disconnected. The provider and client should discuss an emergency procedure for these situations, and verify that they have up-to-date emergency contact information.
  • The provider will maintain a client record for any teletherapy session just like they would if the therapy session had occurred in person. 

Colorado

Age of Consent

In Colorado, generally a client 12 years or older may seek outpatient mental health services. Click for more information. 

 

Informed Consent to Treatment (required)

Counselors, Marriage & Family Therapists, Social Workers, Psychologists 

Providers in Colorado are required to obtain a dated and signed informed consent document covering the following important items not later than the second visit:

  • The provider’s name, business address, and business phone number
  • The provider’s educational, experience, and training requirements applicable to the particular level of regulation
  • A statement indicating that the practice in the field of psychotherapy is regulated by the division, and an address and telephone number for the board
  • The client’s right to receive information regarding methods of therapy, the techniques used, the duration of therapy
  • The client’s right to seek a second opinion and the right to terminate treatment at any time 
  • A statement indicating that the client's records may not be maintained after seven years
  • If the client has no written language or is unable to read, an oral explanation shall accompany the written copy.
  • The provider’s obligations related to confidentiality, as well as the limitations thereof. 


Teletherapy Consent Form (required)

Counselors, Marriage & Family Therapists, Social Workers, Psychologists 

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • The agreed upon therapeutic means of communication between the client and the licensee, certificate, or registrant. (i.e. if/when will face-to-face contact be appropriate, what method(s) of electronic communication will be utilized, what is the structure of the contractual relationship).
  • Procedures for alternative modes of communication when there is possible technology failure.
  • How to cope with potential misunderstandings when the visual cues that would normally occur during face-to-face visits do not exist.
  • How to address crisis intervention when necessary.
  • Encryption methods, firewall, backup systems, and the risk of unsecured communications.
  • Disclosing that health insurance coverage may not exist for psychotherapy service that is provided through technological means.

Click for more information on Colorado Counseling Association’s guidelines on teletherapy and COVID-19 updates.


Mandatory Disclosure Statement (required)

Providers are required to provide clients with a Mandatory Disclosure Statement outlining their qualifications and credentials.

Click for more information on mandatory disclosure.


Surprise Billing Disclosure Statement (required)

Providers are required to provide clients with a disclosure statement discussing the circumstances in which they may receive a “surprise bill.”

Click for more information on Surprise Billing requirements.


D.C. (District of Columbia)

Age of Consent

In D.C., a minor of any age may consent to health services for treatment of a mental or emotional condition and sexually transmitted disease. A minor of any age may consent to health services which they request for the prevention, diagnosis, or treatment of the following medical situations:

  • Pregnancy or its lawful termination.
  • Substance abuse, including drug and alcohol abuse. 
  • A mental or emotional condition and sexually transmitted disease.

Click for more information.


Informed Consent to Treatment (required)

Counselors 

Licensed Professional Counselors must inform clients, preferably in writing, regarding the counseling process and counseling relationship at or before the time it begins and throughout the relationship.

Click for more information.


Marriage & Family Therapists

A LMFT must provide an informed consent form, signed by both parties, which shall notify the client of their rights and the risks involved with the treatment. Click for more information. 

  • The DC Board of Marriage and Family Therapy has also adopted the American Association for Marriage and Family Therapists Code of Ethics which requires the provider to confirm and document that the client was informed of:
       - The client’s capacity to consent. 
       - The adequate information concerning treatment processes and procedures.
       - The potential risks and benefits of treatments.
       - The client’s freedom to consent without undue influence.


Social Workers

D.C.’s Board of Social Work adopted the National Association of Social Workers Code of Ethics and the consent form must discuss:

  • The nature of the treatment, the potential risks involved, alternative treatments, and the voluntary nature of their participation.
  • Involvement of third parties.
  • The provider’s obligations related to confidentiality, as well as the limitations thereof. 
  • Available alternatives to the treatment, as well as their voluntary participation in treatment with an opportunity to ask questions and receive answers.
  • If the provider is a trainee, the client must be informed that the provider is in training and is being supervised with the name of the supervisor.


Teletherapy Consent Form (recommended)

Counselors, Marriage & Family Therapists, Social Workers

As of June 2021, D.C. does not provide guidance for consent to teletherapy for Counselors, M&F Therapists, and Social Workers. However, SonderMind recommends the use of a teletherapy consent form.


Informed Consent to Treatment & Teletherapy (required)

Psychologists

Psychologists licensed in D.C. are required to obtain a dated and signed informed consent document covering the following important items:

  • The nature of the treatment, the potential risks involved, alternative treatments, and the voluntary nature of their participation.
  • Involvement of third parties.
  • The provider’s obligations related to confidentiality, as well as the limitations thereof. 
  • The client must be notified of available alternatives, the voluntary nature of their participation in treatment with an opportunity to ask questions and receive answers.
  • If the provider is a trainee, the client must be informed that the provider is in training and is being supervised with the name of the supervisor.
       - See rules 3.10, Informed Consent, 9.03, Informed Consent in Assessments, and 10.01, Informed Consent to Therapy

Georgia

Age of Consent

In Georgia, a client must be at least 18 years old to consent to therapy. If the client is underage, the written or oral consent of a parent or a legal guardian is required except in emergency circumstances. 


Informed Consent to Treatment (required)

Counselors, Marriage & Family Therapists, Social Workers

Prior to the delivery of services, providers are required to obtain a dated and signed informed consent document. 


Psychologists

Psychologists are required to obtain a dated and signed informed consent document covering the following important items

  • The nature of the treatment, the potential risks involved, alternative treatments, and the voluntary nature of their participation.
  • Involvement of third parties.
  • The provider’s obligations related to confidentiality, as well as the limitations thereof. 
  • The client must be notified of available alternatives, the voluntary nature of their participation in treatment with an opportunity to ask questions and receive answers.
  • If the provider is a trainee, the client must be informed that the provider is in training and is being supervised with the name of the supervisor.
  • See rules 3.10, Informed Consent, 9.03, Informed Consent in Assessments, and 10.01, Informed Consent to Therapy


Teletherapy Consent Form (required)

Counselors, Marriage & Family Therapists, Social Workers

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • Services will be rendered via technology-assisted media.
  • The verbal and written consent shall be documented in the client's record. 
  • Consent must include disclosure of the use of any third party vendor such as a record keeping, billing service or legal counsel.

Psychologists

An additional consent form is required for teletherapy which must be signed, dated, written in a language that is understandable by the client, and discuss:

  • A clear description of those telepsychology services they provide.
  • The manner in which telecommunication will be used and the boundaries they will establish, and the procedures for responding to electronic communications.

Indiana

Age of Consent 

In Indiana, a client must generally be at least 18 years old to consent to therapy except in special circumstances such as emancipation.  


Informed Consent to Treatment (required)

Counselors, Marriage & Family Therapists, Social Workers & Psychologists

Providers in Indiana are required to obtain a dated and signed informed consent document covering the following important items:

  • The provider's training and credentials.
  • The reasonably foreseeable risks and relative benefits of proposed treatments and alternative treatments. 
  • The patient's right to withdraw consent for treatment at any time.
  • The following apply to Counselors only:
       Before providing services, a counselor shall disclose their educational background in the field of counseling, including the following:
          - Whether the counselor has a degree in counseling or a related field.
          - The type of degree issued and the eligible postsecondary educational institution that issued the degree.


Teletherapy Consent Form (required)

Counselors, Marriage & Family Therapists, Social Workers 

As of June 2021, Indiana does not provide guidance for consent to teletherapy for Counselors, M&T Therapists, and Social Workers. However, SonderMind recommends using a teletherapy consent form.


Psychologists

An additional consent form is required for telepsychology which must be signed, dated, written in a language that is understandable by the client, and consistent with accepted professional and legal requirements, concerning the following:

  • The limitations and innovative nature of using telepsychology.
  • Potential risks to confidentiality.
  • Potential risks of sudden and unpredictable disruption and means of reestablishing connection.
  • How and when the provider will respond to routine electronic messages.
  • Who else may have access to communications between the client and the psychologist.
  • Specific methods for ensuring that a client's electronic communications are directed only to the psychologist.

Kentucky

Age of Consent 

In Kentucky, a client must be at least 16 years old to consent to therapy except in special circumstances such as emancipation.


Informed Consent to Treatment (required)

Counselors, Marriage & Family Therapists 

Providers in Kentucky are required to obtain a dated and signed informed consent document covering the following important items:

  • The mental health provider's training and credentials.
  • The reasonably foreseeable risks and relative benefits of proposed treatments and alternative treatments.
  • The patient's right to withdraw consent for treatment at any time.

Social Workers

Prior to treatment, providers in Kentucky are required to obtain a dated and signed informed consent document covering the following important items:

  • The client's condition.
  • The recommended treatment.
  • Reasonable expectations of the benefits from the treatment, as well as the foreseeable risks or negative consequences, and alternative treatment options.
  • The client’s right to refuse treatment.

Psychologists

Prior to treatment, providers in Kentucky are required to obtain a dated and signed informed consent document covering the following important items:

  • The limitations of confidentiality.
  • Disclosure of cost of services.
  • An account of the client’s condition provided to the client or those responsible for the client. 
  • The purpose and nature of an evaluation, treatment or other procedure.
  • The client’s right to freedom of choice regarding services provided. 


Teletherapy Consent Form (required)

Counselors, Marriage & Family Therapists 

An additional consent form is required for teletherapy which must be signed, dated, written in a language that is understandable by the client, and discuss:

  • The provider’s credentials, physical location of practice, and contact information.
  • The risks and limitations of using teletherapy.
  • Potential limitations to confidentiality.
  • Potential risks of sudden and unpredictable disruption and means of reestablishing connection.
  • Possible denial of insurance benefits. 
  • Social media policy. 
  • For Marriage & Family Therapists only:
      - If the service is being rendered to a minor, the provider must verify the identity of the parent, guardian, or other person consenting to the minor's treatment and obtain from that person the informed consent required by this section. 


Social Workers

An additional consent form is required for teletherapy which must be signed, dated, and must assure the confidentiality of a patient's information. 


Psychologists

An additional consent form is required for teletherapy which must be signed, dated and ensure the confidentiality of the patient's medical information. 

Maryland

Age of Consent

In Maryland, generally a client must be at least 16 years old to consent to therapy.


Informed Consent to Treatment (required)

Counselors, Marriage & Family Therapists

Prior to treatment, providers in Maryland are required to obtain a dated and signed informed consent document covering the following important items:

  • The privacy and confidentiality of a client and a client's records
  • The purpose and nature of an evaluation or treatment process, additional options to the proposed treatment, and potential reactions to the proposed treatment
  • The right of a client to withdraw from treatment at any time, including the possible risks that may be associated with withdrawal
  • The right of a client to decline treatment, if part or all of the treatment is to be recorded for research or review by another person


Social Workers

The Board of Social Workers Examiners defines "informed consent" as a client’s decision to agree to a proposed course of transactions between the client and the provider after the client has received reasonably full and accurate information pertaining to the risks, benefits, and possible consequences of the transaction.


Psychologists

Maryland’s Board of Examiners of Psychologists requires a dated and signed informed consent document covering the following important items:

  • Legal and ethical limits of confidentiality
  • For minor clients who have legal guardians, the limits of confidentiality, to the extent that the client can understand, at the beginning of the professional relationship
  • The provider’s duty to inform authorities of abuse and neglect of children and vulnerable adults


Teletherapy Consent Form (required)

Counselors, Marriage & Family Therapists, Social Workers, Psychologists

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • A procedure for verifying identity of the client, data encryption, notifying clients in the event of a data breach; securing teletherapy connection, compliance with federal and state privacy laws, and the safety protocols in the case of an emergency, including contact information for emergency services at the client’s location.
  • Method of contacting the client in case of a technological failure.
  • How to determine whether the client is in Maryland and identify the client’s specific location.
  • At the initial teletherapy session, disclose the provider’s name, location, license number, and contact information.
  • Identify the presence of any third party and confirm they are permitted to hear the client’s health information.
  • The provider will be held to the same standards and regulations as if the session had occurred in person. 

Missouri

Age of Consent

In Missouri, generally a client must be at least 18 years old to consent to therapy. A minor who is 16 or 17 years old may consent if they meet specific criteria. 


Informed Consent to Treatment (required)

Counselors and Marriage & Family Therapists

Prior to treatment, providers in Missouri are required to obtain a dated and signed informed consent document covering the following important items:

  • The provider’s qualifications and credentials. 
  • The goals of the therapeutic relationship, the services to be provided, and the associated risks and benefits.
  • The expected behavior of the client.
  • If recording sessions, how the recording will be used and stored. 
  • The provider’s obligations related to confidentiality, as well as the limitations thereof.
  • The provider must disclose the voluntary or mandatory nature of the treatment. When the therapy is voluntary, the provider must inform the client of the freedom of choice and any alternatives.
  • The following apply to Counselors only:
       - If technology is used in the course of counseling, how such technology is in compliance with federal and state legal and ethical requirements.
       - If an individual, other than the provider, is able to obtain access to confidential information, the provider must disclose this possibility to the client.
  • The following apply to Marriage & Family Therapists only:
       - If providing information to third parties, a release of information must be signed by all participants in therapy.
       - The provider must inform the purpose and nature of the treatment


Social Workers

Prior to treatment, providers in Missouri required to obtain a dated and signed informed consent document covering the following important items:

  • The purposes, goals, techniques, rules of procedure. 
  • Limitations that may affect the professional relationship.
  • Whether sessions will be recorded and how such recordings will be used. 


Psychologists

Prior to treatment, psychologists in Missouri are required to obtain a dated and signed informed consent document covering the following important items:

  • All aspects of services including assessment and therapy.
  • If a provider is provisionally licensed - the fact that you are working under the supervision of a licensed psychologist and identify the supervising psychologist.
  • The purpose and nature of any evaluation, treatment or other procedures 
  • The client’s right to freedom of choice regarding services.

Nebraska

Age of Consent

In Nebraska, generally a client must be at least 18 years old to consent to therapy unless they are a ward of the state.


Informed Consent to Treatment (required)

Psychologists

Prior to treatment, providers in Nebraska are required to obtain a dated and signed informed consent document covering the following important items:

  • Any conflict of interest
  • The nature of the relationship to all parties directly affected by the services.
  • Any known bias or prejudice which seriously affects the provider’s objectivity in dealing with the client.


Teletherapy Consent Form (required)

Counselors, Marriage & Family Therapists, Social Workers, Psychologists

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • The client’s right to refuse at any time.
  • A statement that all existing confidentiality protections shall apply to the telehealth consultation.
  • A statement that the patient shall have access to all medical information resulting from the telehealth consultation as provided by law for patient access to his or her medical records.
  • A statement that dissemination of any patient identifiable images or information from the telehealth
  • consultation to researchers or other entities shall not occur without the written consent of the patient.
  • The client’s understanding of the written consent and the discussion between the provider and the client

Ohio

Age of Consent

In Ohio, generally a client must be at least 18 years old to consent to therapy. However, a minor 14 years of age or older can consent to therapy, up to 6 sessions or 30 days of service, whichever occurs first. 


Informed Consent to Treatment (required)

Counselors, Marriage & Family Therapists, Social Workers

Prior to treatment, providers in Ohio are required to obtain a dated and signed informed consent document covering the following important items:

  • The nature, extent, purpose, limitations, and risks of services.
  • The client’s right to refuse or withdraw consent, and the timeframe the consent covers.
  • Any involvement of third parties. 
  • When a court orders an evaluation, the provider must inform the client of the parameters of the order and must not go beyond the parameters.
  • The provider must clarify their role/obligations/limits of confidentiality if providing services to two or more clients or if there is an anticipated conflict of interest. 
  • Communication must be developmentally and culturally appropriate (i.e. if a client is unable to read or understand the document, or if a client requires a translator). 
  • For Counselors only, additional & mandatory informed consent requirements can be found through the American Counseling Association.
  • For Marriage & Family Therapists only, additional & mandatory informed consent requirements can be found through the American Association for Marriage and Family Therapy Code of Ethics.
       - The client must be adequately informed of significant information concerning treatment processes and procedures
       - The potential risks and benefits of treatments 


Psychologists

Prior to treatment, psychologists in Ohio are required to obtain a dated and signed informed consent document covering the following important items or documentation justifying why a signed form was not feasible.

  • The provider must give each client informed choice, confidentiality, and reasonable protection from physical or mental harm or danger.
  • The purpose and need for the third party. 
  • The purpose and nature of any treatment or other procedures. 
  • If services involve a court order, the provider must inform the parameters of the court order and shall not provide services or opinions beyond the parameters of the order.
  • If providing services to two or more clients, the provider must clarify with all parties and document the parties' understanding about how records of the services will be maintained, who has access to the records, and any limits of access to the records.


Teletherapy Consent Form (required)

Counselors, Marriage & Family Therapists, Social Workers

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • Confidentiality in teletherapy service delivery and records maintenance shall be maintained by the provider. 
  • The provider must develop and disclose policies for data privacy & security.
  • The limitations and risks in telepractice including confidentiality risks, and potential technology failures leading to the provider and client being disconnected. 
  • During the COVID-19 state of emergency declared by the governor, the provider may provide services without completing an initial face to face video or in-person session; obtain and record verbal acknowledgement of informed consent when it cannot be obtained in writing; and follow HIPAA requirements.


Psychologists

In addition to a written informed consent for treatment, another consent form is required for teletherapy. This form must also be dated and signed, and must discuss:

  • The limitations and risks in teletherapy including confidentiality risks, potential technology failures, emergency procedures in these situations, and the importance of up-to-date  emergency contact information.
  • Who else may have access to communications between the client and the provider.
  • Specific methods for ensuring that a client's electronic communications are directed only to the provider or supervisee
  • How the provider will store client information.

Texas

Age of Consent

In Texas, generally a client of age 16 years or older may consent to mental health treatment.

Click for more information.


Informed Consent to Treatment (required)

Counselors

Prior to treatment, providers in Texas are required to obtain a dated and signed informed consent document covering the following important items:

  • The purposes, goals, and techniques of the treatment
  • The provider’s obligations related to confidentiality, as well as the limitations thereof. 
  • Any intent of the provider to use another professional for treatment
  • If the provider is a trainee, the client must be informed with the name, address, contact information and qualifications of the supervisor
  • Any restrictions the The Texas Behavioral Health Executive Council placed on the provider
  • The name, address and telephone number of the Council for reporting violations
  • An established plan for the custody and control of the client's mental health records in the event of the provider’s death or incapacity, or termination of treatment

Click for more information.


Marriage & Family Therapists

Prior to treatment, providers in Texas are required to obtain a dated and signed informed consent document covering the following important items:

  • Important aspects of the therapeutic relationship, including the provider’s status as an LMFT or a LMFT association, and any probation or restrictions on the license.
  • The provider must make reasonable efforts to determine any modifications of parental rights of the client by a court. 
  • The minor client who is named in a custody agreement or court order, the provider must obtain and review a current copy of the custody agreement or court order, keep the document in the client’ record, and follow federal/state statutes on parental consent.
  • The provider’s obligations related to confidentiality, as well as the limitations thereof.
  • Any after-hours coverage and the provider’s office procedures.

Click for more information.


Social Workers form Minors only:

  • The provider’s qualifications and any intent to delegate service provision
  • Any restrictions the The Texas Behavioral Health Executive Council has placed on the provider’s license
  • The limits on confidentiality and privacy
  • For treatment provided for a minor client named in a Suit Affecting Parent Child Relationship (SAPCR), all legally authorized persons representing the client must sign a consent

Click for more information.


Psychologists

Prior to treatment, psychologists in Texas are required to obtain a dated and signed informed consent document covering the following important items:

  • All services and the nature of the services to be provided.
  • Appropriate information as needed, during the course of the services.
  • The nature of the relationship at the onset and at any time during the services that the circumstances change.
  • All potential limits to confidentiality.
  • Limitations to confidentiality in a group therapy environment
  • The potential conflict to all affected parties and adjust or withdraw from all services in accordance with The Texas Behavioral Health Executive Council rules and applicable state and federal law.
  • Inform clients of any conflicts of interest and discuss appropriate termination and referral.

Teletherapy Consent Form (required)

Marriage & Family Therapists 

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • Definition of electronic service delivery and the potential risks and ethical considerations. 
  • The client’s consent for the use of technology-assisted services.
  • Identification of the client, the provider, and the provider’s credentials.
  • The technology-assisted services being provided.
  • The client’s agreement that the provider will determine on an on-going basis whether the client’s condition is appropriate for technology-assisted services.
  • The security measures taken with the use of technology-assisted services, as well as potential risks to privacy.
  • The back-up plans in case of technical failure.
  • The provider’s credentials or training to engage in technology-assisted services, and contact information.
  • The risks and benefits of engaging in the use of technology.
  • Emergency procedures to follow when the provider is not available.
  • Information collected and any tracking mechanisms.
  • Third-party websites or services used by the provider to facilitate technology-assisted services.
  • An explanation of record-keeping, including encryption type and record security, and the archival storage period for transaction records.

Click for more information.


Virginia

Age of Consent

In Virginia, generally a client of any age may consent to treatment for mental illness or emotional disturbance.

Click for more information


Informed Consent to Treatment/Teletherapy (required)

Counselors, Marriage & Family Therapists, Social Workers

Prior to treatment and regardless of method of delivery, providers in Virginia are required to obtain a dated and signed informed consent document covering the following important items:

  • The purposes, goals, techniques, procedures, limitations, risks, and benefits of treatment.
  • The provider’s obligations related to confidentiality, as well as the limitations thereof. 
  • Any implications of diagnosis, the intended use of tests and reports.
  • The provider must follow the same code of ethics when providing teletherapy services as in in-person setting.

Click for more information on COVID-19 Update (Virginia Board of Counseling)


Psychologists

Prior to treatment, psychologists in Virginia are required to obtain a dated and signed informed consent document covering the following important items:

  • The provider’s services
  • The provider’s obligations related to confidentiality, as well as the limitations thereof.
  • The provider avoids bartering goods and services, and will only participate if it is not clinically contraindicated nor exploitative

Click for more information (Board of Psychology)


Teletherapy Consent Form (required)

Social Workers 

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • Information on technology use in service delivery.
  • The provider obtains authorization of information disclosure and consent for treatment.
  • The provider takes proper steps to protect the client's privacy and notifies client of privacy practices and risks involving technology including wireless devices.

Click for more information (Virginia Board of Social Work)


Psychologists

An additional consent form is required for teletherapy which must be signed, dated and discuss:

  • The limitations and potential risks to confidentiality of information related to distance technology.
  • Potential risks disruption of telepsychology services and an alternative means of re-establishing connection.
  • When and how the provider will respond to electronic messages.
  • Under what circumstances an alternative means of communications will be used.
  • Specific methods for ensuring that a client's communications are directed only to the provider.
  • How the provider stores electronic communications and who else has access to such communications.
By
Reviewed By

**Disclaimer: This document is intended for educational purposes only. Please check with your legal counsel or state licensing board for specific requirements.

SonderMind Inc.© 2021

Learn more about how partnering with SonderMind can redesign your practice.