AI Therapy Notes Consent Form: A Free Template Built Around the 2026 State Laws

By The Professions Cloud Editors Updated October 2026 · 6 sources · 4 min read

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

Why this exists: several states now require written, informed consent before AI records or transcribes a therapy session. Colorado's HB 26-1195 has required it since August 12, 2026 (Colorado General Assembly), and Rhode Island since June 2026 (Transparency Coalition). Illinois requires written, revocable consent for AI supplementary support (Baker Botts), and Louisiana requires a verbal disclosure before AI-transcribed recording (Arnall Golden Gregory).

Below is a template that covers the common requirements, followed by the clause-by-clause reasoning.

What the laws require a consent process to cover

Sources: Snell & Wilmer; Nixon Peabody; Arnall Golden Gregory. Our AI scribe consent laws guide covers each law in detail.

The template

Consent to the Use of an AI Documentation Tool

[Practice name] · [Clinician name, license type and number]

What we'd like to use. With your permission, I use [tool name], an artificial intelligence (AI) documentation tool, to help write my clinical notes. During sessions where you agree, the tool [records / transcribes] our conversation and produces a draft note.

Why. Using this tool lets me spend less time on paperwork and more attention on you during our sessions.

What the tool does not do. The tool does not provide therapy, make treatment decisions or diagnose you. I review, correct and approve every note before it becomes part of your record. I remain fully responsible for your care.

What happens to your information.

• Audio and transcripts are [deleted immediately after the note is approved / kept for [X] days, then deleted].
• The vendor [does not / does] use your information to train its AI. [Describe accurately.]
• The vendor has signed a Business Associate Agreement and must protect your information under HIPAA.
• Information is stored [location/description from vendor documentation].

Your choices.

• Saying no will not affect your care in any way. I will take notes another way.
• You can change your mind at any time, including partway through a session, by telling me. I will stop using the tool from that point.
• You can ask me any questions about the tool before deciding.

Changes. If I change tools or start using AI for a different purpose, I will ask for your consent again.

☐ I agree to the use of the AI documentation tool described above. ☐ I do not agree. Please take notes without it.

Client name: __________________ Signature: __________________ Date: __________

Clinician signature: __________________ Date: __________

Why each clause is there

• Tool name and what it does: "informed" consent means the client knows what's being used. A vague "we may use technology" line isn't enough under Colorado's "disclose in advance the use… and the purposes" standard (Colorado General Assembly).
• "Does not provide therapy": Colorado and Illinois restrict AI from therapeutic decisions and communication, so the form makes the tool's limited role clear.
• Data handling: clients reasonably ask where recordings go. Fill this in from your vendor's BAA and documentation, not marketing copy.
• No effect on care: Colorado prohibits denying services to clients who refuse or revoke (Snell & Wilmer), and it's good practice everywhere.
• Revocation and re-consent: required in Colorado and Illinois.

How to use it

1. Adapt the brackets to your actual tool and settings.
2. Have it reviewed by counsel or your board's guidance, especially if you practice across states.
3. Explain it out loud at the first session. That also covers Louisiana's verbal disclosure.
4. Store the signed form in the client's record, and note revocations immediately.
5. Re-run consent if you switch vendors.

Choosing a tool? Compare AI progress note tools, and see the HIPAA side in AI note takers and HIPAA consent.

FAQ

Do I need written consent in every state?

No, but a growing number require it, and written consent satisfies both the consent and disclosure states. It's the simplest safe default.

Can I put this in my general intake paperwork?

You can include it in the intake packet, but keep it a separate, clearly labeled form with its own signature, so consent is specific and informed.

What if a client revokes consent mid-session?

Stop the tool immediately, note the revocation, and document the session another way.

Changelog: Oct 13, 2026: first published.