Counseling Consent template

1. Nature of Counselling

• Counselling offers a confidential space to explore thoughts, feelings, and difficulties. Sessions typically last 50 minutes and take place at an agreed frequency. Counselling is not a medical treatment and does not replace psychiatric or medical care where needed.

2. Risks and Benefits

• Counselling can bring up difficult emotions before things improve. Many clients find it helpful for managing distress and gaining insight, though outcomes vary and are not guaranteed.

3. Confidentiality and Its Limits

• What is discussed in sessions is confidential, except where I disclose risk of serious harm to myself or others, where a child or vulnerable adult may be at risk, or where disclosure is required by law. My counsellor may discuss anonymised material in clinical supervision.

4. Data Protection

• Session notes are stored securely and processed under the UK GDPR and Data Protection Act 2018. I may request access to my records at any time.

5. Cancellation Policy

• I agree to give at least 48 hours' notice to cancel or reschedule a session; missed sessions or late cancellations will be charged in full.

6. Right to Withdraw

• I understand I may end counselling at any time, and that I am encouraged to discuss this decision with my counsellor first.

Client Information

• Full NameText
• Date of BirthDate
• AddressText
• Phone / EmailText

Counsellor Information

• Counsellor NameText
• Accreditation No.Text

Emergency Contact

• Contact NameText
• Relationship / PhoneText

Acknowledgment and Signature

• Client SignatureSignature
• Date signed (client)Date
• Counsellor SignatureSignature
• Date signed (counsellor)Date

• By signing below, I confirm I have read and understood this consent form and voluntarily agree to begin counselling.