The Center For Ethical Practice | Sample Handouts & Patient Consent Forms

Practice Resources

Sample Handouts & Patient Consent Forms

Sample Handouts & Patient Consent Forms

NOTE: Clinicians must “personalize” some of these forms to reflect policies in their own settings

Adolescent Informed Consent Form

Agreement for Confidentiality of Individual Treatment

Confidentiality Contract for Marital or Couple Therapy

Couple Informed Consent Form

Custody Agreements

Informed Consent For Clinical Consultation (Consultant-Consultee Contract)

Informed Consent for Therapy Services – Adult

Informed Consent Form Child Therapy: Separated/Divorced Parents

Notice of Privacy Policies – Client Handout

Notice of Privacy Practices With Links to Relevant Laws (for Therapist Reference)

Sample Non-Subpoena Contract for Clients in Couple, Family, or Child/Parent Therapy

Print This Page

Print This Page