Free templates
Tell clients about AI tools the way you'd want to be told.
Two templates: full consent for recorded sessions, and a lighter disclosure for dictation-only workflows where the client is never recorded.
These templates are a starting point, not legal advice. Review with your own counsel and adapt to your jurisdiction, license requirements, and practice policies before use.
Consent to record sessions for AI-assisted note drafting
Use when sessions are audio-recorded and processed by an AI tool to draft progress notes.
What is recorded and why
With your permission, our sessions will be audio-recorded for the sole purpose of preparing my clinical notes. The recording helps me document accurately while staying present in our conversation.
How the recording is processed
Recordings are transcribed and a draft note is prepared using software running on my own computer. [If using CouchNotes or another on-device tool:] The audio is processed entirely on my device — it is not uploaded to any cloud service, and no other company receives or stores it.
What happens to the audio
The recording is deleted once the session note is finalized, typically within [X days] of our session. Only the written clinical note becomes part of your record.
I review every note
Software prepares a draft only. I personally review, correct, and approve every note before it enters your record. Clinical judgment is never delegated to the software.
Your choice, anytime
Recording is voluntary. You may decline now or withdraw consent at any session, verbally or in writing, with no effect on your care. If you decline, I will take notes by dictating a summary after our session instead — you will never be recorded.
Acknowledgment
Client name, signature, and date. Clinician name, signature, and date. [Optional: guardian signature for minors.]
Disclosure of AI-assisted documentation (no client recording)
Use when the clinician dictates a post-session summary — the client is never recorded, but AI still assists with documentation. Disclosure builds trust even where consent is not strictly required.
How I prepare your notes
After our sessions, I dictate a brief clinical summary in my own words. Software on my computer converts that dictation into a structured draft note, which I review and finalize.
You are not recorded
Our sessions themselves are not recorded in any form. The only audio involved is my own voice, after you have left.
Where the processing happens
[If using an on-device tool:] All processing happens on my own computer. Nothing about your care is uploaded to a cloud service or shared with a software vendor.
Questions welcome
I am happy to explain how this works or show you the tool. You may also request that I prepare your notes fully by hand, with no effect on your care.
Acknowledgment
Client name, signature, and date. Clinician name, signature, and date.
Take both forms with you
One PDF, both templates, ready to adapt on your letterhead. Leave an email and it's yours — you'll also hear when CouchNotes opens its beta.
Also free: SOAP, DAP & BIRP note templates.