What is an informed consent form?
An informed consent form records that a client understands what to expect from your service and agrees to proceed. It is usually signed before or at the first session.
- About the service: What you offer, how sessions work and what the client can expect.
- Confidentiality: How you protect the client’s information and any limits that apply.
- Fees and cancellations: What sessions cost, how and when to pay, and your cancellation policy.
- Agreement: The client’s confirmation and signature, with the date.
Plain-language consent forms build trust and prevent misunderstandings about fees, boundaries and privacy.
Informed Consent Form
Informed Consent Form
Informed Consent Form Example
How to use this informed consent form
The template is designed to be quick to complete. Follow these four steps.
Step 1: Download the form
Download the blank form and print it, or complete it on screen.
Step 2: Adapt it to your practice
Edit the wording so it reflects your service, fees and policies. Have it reviewed by a qualified professional if you are unsure.
Step 3: Go through it with the client
Walk through the key points and invite questions before they sign.
Step 4: Sign and store securely
Both parties sign and date. Keep a copy with the client record in a secure place.
Who can use this consent form?
Practitioners who see clients one to one, including:
- Massage therapists
- Chiropractors and bodyworkers
- Counsellors and therapists
- Wellness practitioners
- Solo practices
- Clinics with several practitioners
Consent requirements differ by profession and region. This template is a starting point, not legal advice.
Why is a consent form useful for practitioners?
Written consent helps in three ways:
- Clarity: clients know what to expect, including fees and policies.
- Trust: open, plain-language terms show respect for the client.
- Protection: a signed record helps both you and the client if questions arise.
Benefits of using an informed consent form
Fewer misunderstandings
Written terms reduce disputes about fees and cancellations.
Respect for privacy
Explaining confidentiality up front builds trust.
Clear boundaries
Setting out how you work helps clients feel safe.
A signed record
A dated signature documents that the conversation took place.
Consistent practice
Every client receives the same information.