Therapy Consent Form

The Therapy Consent Form is a document that is used by a therapist to obtain consent from a patient for treatment. The form usually includes all relevant information about the treatment, including the risks and benefits. It should also explain the patient's rights and responsibilities.

2 minutes to complete


The therapy consent form should be filled out and signed by the patient or by the parent/guardian in case the patient is below 18 years of age and is seeking therapy treatment. The consent form should be filled out by a patient who has been diagnosed with a mental condition by a qualified healthcare professional. The consent form should be filled out by a patient who is seeking therapy.


Questions for Therapy Consent Form



Patient Name

The answer should be a text input.

Patient Address

The answer should be a text input.

Patient Phone Number

The answer should be a phone number.

Patient Email

The answer should be an email input.

Date of Birth

The answer should be a date input.

Therapist Name

The answer should be a text input.

Please select the items that you believe is affecting you.

The answer should be a multiple choice:
  1. Alcohol/Drugs
  2. Anxiety
  3. Stress
  4. Relationship
  5. Sadness/Depression
  6. Sleep disorder
  7. Procastination
  8. Traumatic experiences

I hereby give my consent to participate in the therapy session with my therapist.

The answer should be a single choice:
  1. I Agree
  2. I Disagree


The answer should be a signature.


The answer should be a date input.

Forms Similar to Therapy Consent Form

  • Psychotherapy Consent Form
  • Informed Consent for Psychotherapy
  • Consent to Treatment
  • Psychotherapy Patient Bill of Rights
  • Therapy Consent Form for Minors
  • Couples Therapy Consent Form

Here are some FAQs and additional information
Therapy Consent Form

What is therapy?

Therapy is a process of working to improve your mental and emotional well-being. It can help you to understand and work through difficult experiences, develop new skills and perspectives, and make positive changes in your life.

What can I expect from therapy?

The focus and format of therapy will be based on your needs and goals. In general, therapy involves meeting with a therapist on a regular basis (usually once a week) to talk about your thoughts, feelings, and experiences. The therapist will provide guidance and support as you work to improve your well-being.

What is the purpose of the therapy consent form?

Purpose of a therapy consent form is to inform clients, patients, or subjects of what information you're obtaining, what rights they're waiving, and other pertinent details

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