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Consent & Disclosure Paperwork Template
It can be scary to start a private practice. It can be even scarier when that practice is all online. This is a template of the informed consent I use for my online practice. It has language for both online and in-person therapy. Additionally, I have put in considerations for international therapy practices, and DUE TO POPULAR DEMAND, included a Gaming Consent form. This Template has my Professional Disclosure Statement, my Informed Consent, my Electronic Payment Consent, and Gaming Consent. Additionally, tips and tricks are given for online therapy, including links to tutorials for popular HIPAA compliant video conferencing software, and assisting clients in troubleshooting.
This Template Includes:
Risks and benefits of therapy (specifically individual, couples, and family)
Risks and benefits of online therapy (specifically individual, couples, and family)
Risks and benefits of using gaming in therapy
Addressing dual relationships (in-person and online), including cases regarding providing treatment to multiple family/household members
Limits to confidentiality (for in-person and online therapy)
Telehealth best practice pieces
Billing and payment for private pay clients (and an explanation of superbills)
A fee structure that addresses glitches
Additional Paperwork Provided:
Welcome letter with links on telehealth laws
Checklist for ensuring progress notes reflect best practices and legal and ethical considerations for online therapy
It can be scary to start a private practice. It can be even scarier when that practice is all online. This is a template of the informed consent I use for my online practice. It has language for both online and in-person therapy. Additionally, I have put in considerations for international therapy practices, and DUE TO POPULAR DEMAND, included a Gaming Consent form. This Template has my Professional Disclosure Statement, my Informed Consent, my Electronic Payment Consent, and Gaming Consent. Additionally, tips and tricks are given for online therapy, including links to tutorials for popular HIPAA compliant video conferencing software, and assisting clients in troubleshooting.
This Template Includes:
Risks and benefits of therapy (specifically individual, couples, and family)
Risks and benefits of online therapy (specifically individual, couples, and family)
Risks and benefits of using gaming in therapy
Addressing dual relationships (in-person and online), including cases regarding providing treatment to multiple family/household members
Limits to confidentiality (for in-person and online therapy)
Telehealth best practice pieces
Billing and payment for private pay clients (and an explanation of superbills)
A fee structure that addresses glitches
Additional Paperwork Provided:
Welcome letter with links on telehealth laws
Checklist for ensuring progress notes reflect best practices and legal and ethical considerations for online therapy