Get the free Telehealth Counseling Consent Form Template JotForm

Icier Counseling, LLC Sherry Hopkins, MS, LEFT INFORMED CONSENT ADDENDUM FOR ONLINE THERAPY This form is designed to allow you to give informed consent for the use of video technology for online therapy.

How to fill out telehealth counseling consent form

How to fill out telehealth counseling consent form

1. Download the telehealth counseling consent form from the counseling provider's website or request a copy from them.
2. Read the form carefully to understand the purpose and requirements of telehealth counseling.
3. Provide your personal information such as name, date of birth, address, and contact details as requested in the form.
4. Review and acknowledge the privacy and confidentiality policies stated in the form.
5. Ensure you comprehend the risks and benefits of utilizing telehealth counseling services.
6. Sign and date the consent form to indicate your agreement to participate in telehealth counseling.
7. If applicable, provide any additional information or signatures required by the counseling provider.
8. Submit the completed consent form to the counseling provider through their preferred method (e.g., email, fax, portal).

Who needs telehealth counseling consent form?

1. Anyone who wishes to engage in telehealth counseling services needs to complete a telehealth counseling consent form.
2. This includes individuals seeking remote mental health support, therapy, counseling, or any other form of professional assistance delivered through telecommunication technology.
3. Both new clients/patients and existing ones may be required to complete this form to ensure informed consent and adherence to legal and ethical guidelines.
4. Minors may also require their legal guardians or parents to complete the consent form on their behalf.

For pdfFiller’s FAQs

How do I modify my telehealth counseling consent form in Gmail?

You can use pdfFiller’s add-on for Gmail in order to modify, fill out, and eSign your telehealth counseling consent form along with other documents right in your inbox. Find pdfFiller for Gmail in Google Workspace Marketplace. Use time you spend on handling your documents and eSignatures for more important things.

How do I edit telehealth counseling consent form on an iOS device?

Create, modify, and share telehealth counseling consent form using the pdfFiller iOS app. Easy to install from the Apple Store. You may sign up for a free trial and then purchase a membership.

How do I edit telehealth counseling consent form on an Android device?

With the pdfFiller mobile app for Android, you may make modifications to PDF files such as telehealth counseling consent form. Documents may be edited, signed, and sent directly from your mobile device. Install the app and you'll be able to manage your documents from anywhere.

What is telehealth counseling consent form?

A telehealth counseling consent form is a document that informs clients about the nature of telehealth services, outlines the counselor's qualifications, and ensures that clients give their informed consent to participate in remote counseling sessions.

Who is required to file telehealth counseling consent form?

Counselors and mental health professionals providing telehealth services are typically required to file a telehealth counseling consent form for each client.

How to fill out telehealth counseling consent form?

To fill out a telehealth counseling consent form, clients should provide personal information, acknowledge understanding of telehealth services, consent to treatment, and may need to answer specific questions regarding their health and treatment preferences.

What is the purpose of telehealth counseling consent form?

The purpose of a telehealth counseling consent form is to ensure that clients are fully informed about the telehealth process, including potential risks and benefits, and to document their consent for treatment.

What information must be reported on telehealth counseling consent form?

The telehealth counseling consent form must report client's personal information, informed consent to engage in telehealth services, understanding of confidentiality limits, and acknowledgment of the nature of the services provided.