AI Scribes in Therapy Sessions: The New State Consent Laws (Colorado, Rhode Island, Louisiana)

By The Professions Cloud Editors Updated October 2026 · 5 sources · 3 min read

Prices and facts checked October 13, 2026. We don't accept payment for rankings.

What happened: three states this summer wrote AI note-taking into law. Colorado's HB 26-1195 took effect August 12, 2026 and requires written, informed consent before AI records or transcribes a psychotherapy session (Colorado General Assembly). Rhode Island enacted three AI laws on June 22, 2026, including written consent for AI use in recorded therapy sessions and notice for AI scribes generally (Transparency Coalition). Louisiana's Act 649 has required verbal disclosure before AI-transcribed recording since August 1, 2026 (Arnall Golden Gregory).

Why it matters today: if you use an AI scribe like Upheal, Mentalyc or SimplePractice's note tools, your consent process is now a legal requirement in more states, not just good practice. And because these laws follow where the client is, telehealth practices must meet the rules of every state they serve.

The laws side by side

Sources: Colorado General Assembly; Snell & Wilmer; Nixon Peabody; Transparency Coalition; Arnall Golden Gregory.

Colorado in detail

Under HB 26-1195, a psychotherapy provider must (Snell & Wilmer):

• get clear, written, revocable consent before AI records or transcribes. One-time consent is enough unless the purpose or method materially changes
• not deny services to a client who refuses or revokes consent
• review and approve any AI-generated treatment recommendations or plans
• not let AI hold therapeutic conversations unless the provider is present in real time

Penalties: licensing discipline, administrative fines up to $5,000, and civil penalties up to $20,000 under the Colorado Consumer Protection Act. Providers aren't liable for defects attributable to the AI's developer.

Consent vs disclosure

• Consent states (Colorado, Rhode Island for therapy, Illinois): the client must agree in writing before recording.
• Disclosure states (Louisiana): you must tell the client before recording; consent isn't required by that law, though recording-consent laws may still apply.
• Everywhere: HIPAA, your BAA with the vendor, and all-party recording consent laws in some states still apply (our HIPAA consent guide).

Simplest approach: use written consent everywhere. It satisfies the strictest states and builds client trust.

A consent workflow that covers all of these

1. Intake form: a separate AI note-taker consent explaining what's recorded, why, where it's stored, how long, and that the client can say no or change their mind.
2. First session: say it out loud too (this covers Louisiana's verbal disclosure) and note it in the chart.
3. Offer a no-AI option with no change to care.
4. Re-consent if you change tools or start using AI for something new.
5. Review every AI note for accuracy before signing (Rhode Island requires it, and it's good practice).
6. Record revocations immediately and switch off the scribe for that client.
7. Check your vendor's settings: audio deletion after note approval, no training on client data, signed BAA.

Choosing a tool? See our AI progress notes comparison. For the broader picture of AI therapy bans, see state AI therapy laws.

FAQ

Does Colorado require consent for every session?

No. One-time written consent is enough unless the purpose or manner of AI use materially changes.

Can I require AI scribe consent as a condition of treatment?

Not in Colorado, and conditioning care on consent is risky everywhere. Offer a no-AI path.

My client is in another state for a telehealth session. Whose law applies?

Generally the client's location. Apply the strictest rule that could apply.

Changelog: Oct 13, 2026: first published.