A Telehealth Behavioral Consent, also called a teletherapy consent, is a form that documents a client's informed agreement to receive mental health care through video or phone sessions. Therapists, counselors, and psychologists use it to explain privacy, technology risks, and emergency procedures before virtual treatment begins. This template is a starting point, so confirm the final wording with your own compliance or legal counsel.
What does a Telehealth Behavioral Consent include?
Content varies by state and practice, but most teletherapy consents cover the same core sections that explain how virtual care works and what the client is agreeing to.
- Client and provider details. Records the client's name, the provider's name and credentials, and the practice offering telehealth services.
- Description of telehealth services. Explains how sessions are delivered by video or phone and how virtual care differs from in-person visits.
- Privacy and confidentiality. Describes how the client's information is protected and the limited situations in which it may be disclosed.
- Technology risks and limitations. Notes that connection failures, interruptions, or security risks can affect a virtual session.
- Emergency and safety protocol. Explains what the provider does in a crisis and asks the client for an emergency contact and current location.
- Private location and identity. Asks the client to join from a private, quiet space and to confirm their identity for each session.
- Right to withdraw consent. States that the client may stop telehealth and request in-person care at any time.
- Fees and insurance. Outlines how telehealth sessions are billed and any coverage or payment terms that apply.
- Acknowledgment and signature. Captures the client's signature and date confirming they understand and agree to virtual care.
How to administer the Telehealth Behavioral Consent
- Send the consent to the client before their first virtual session, by email or text link.
- Ask the client to read each section, including privacy, technology risks, and emergency procedures.
- Have the client confirm their identity and current physical location for the session.
- Collect the client's electronic signature and the date before care begins.
- Store the signed consent securely so it is ready before the visit.
- For returning clients, send an updated version to re-sign when services or state rules change.
Who uses the Telehealth Behavioral Consent?
- Therapists and counselors providing individual, couples, or family sessions by video or phone.
- Psychologists and psychiatrists delivering assessment, therapy, or medication management remotely.
- Group practices and behavioral health clinics standardizing consent across multiple providers and states.
- Substance use and community mental health programs documenting consent alongside federal confidentiality rules.
Digital vs paper Telehealth Behavioral Consent
| Paper | Zentake digital |
|---|---|
| Handwriting can be hard to read | Typed responses are clear and complete |
| Clients fill it out in the waiting area | Clients complete it at home before the session |
| Requires a printed form to sign | Legally captured e-signature before the visit |
| Paper is stored in binders or filing cabinets | Encrypted, HIPAA-compliant digital storage |
| Updates require reprinting and re-signing | Returning clients re-sign an updated version online |
| Staff scan and file each form by hand | Completed forms are ready before the visit, no scanning |
How Zentake helps with the Telehealth Behavioral Consent
- E-signatures. Clients sign the teletherapy consent online with a legally captured signature that records who agreed and when.
- Custom form builder. Build state-specific consent variants and adjust wording to match your practice and payer requirements.
- Before the visit. Send the consent so mental health practices have it signed and ready before the first virtual session.
- HIPAA compliant. Every form is encrypted and covered by a signed BAA on every plan.
- In-clinic tablets. For clients who start care in person, capture consent at check-in on a tablet.
References
The U.S. Department of Health and Human Services (HHS) publishes guidance on informed consent for telebehavioral health, noting that most states require providers to obtain a client's informed consent before delivering care by telehealth, and that consent may be documented in writing, electronically, or verbally. See the HHS telehealth best-practice guides. Requirements vary by state and payer, so confirm specifics with your state licensing board and legal counsel.
Last updated: August 2026