Psychotherapy Consent template

1. Nature of Psychotherapy

• Psychotherapy is a talking treatment that explores thoughts, feelings, and patterns of behaviour over a series of sessions, typically 50 minutes each, at a frequency agreed with my therapist.

2. Risks and Benefits

• Psychotherapy can bring up difficult feelings, memories, or relational patterns before insight and change develop. Many clients experience significant benefit; outcomes vary and are not guaranteed.

3. Confidentiality and Its Limits

• What I share is confidential, except where there is risk of serious harm to myself or others, a safeguarding concern, or a legal requirement to disclose. My therapist may discuss anonymised material in clinical supervision, as required by professional bodies.

4. Data Protection

• Session notes are stored securely and processed under the UK GDPR and Data Protection Act 2018.

5. Fees and Cancellation

• Fees are payable as agreed. I agree to give at least 48 hours' notice to cancel or reschedule; missed sessions or late cancellations will be charged in full.

6. Ending Therapy

• I understand I may end therapy at any time, and am encouraged to discuss this with my therapist so we can plan a considered ending together.

Client Information

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

Therapist Information

• Therapist NameText
• Registration No.Text

Emergency Contact

• Contact NameText
• Relationship / PhoneText

Acknowledgment and Signature

• Client SignatureSignature
• Date signed (client)Date
• Therapist SignatureSignature
• Date signed (therapist)Date

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