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Informed Consent Guidelines Form Mobile App

The Informed Consent Guidelines Form mobile app was created for therapists to make it easy for patients and therapists to complete an Informed Consent Guidelines form using a mobile device. This app has the potential to be made HIPAA compliant. You can set GoCanvas so an email entered in a field will automatically be pulled into the Email Recipients list at the end of the app.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Informed Consent Guidelines Form Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico multiline

    Confidentiality:

  • Ico multiline

    Record Keeping System:

  • Ico multiline

    Therapist Title:

  • Ico multiline

    Education and Professional Training:

  • Ico multiline

    Informed Consent:

  • Ico multiline

    The clinical scope of my practice:

  • Ico multiline

    Areas I am not trained in:

  • Ico multiline

    Risks of Therapy:

  • Ico multiline

    Alternate approach:

  • Ico multiline

    Fees and billing practices:

  • Ico multiline

    Patient Right to not use the Session:

  • Ico multiline

    Emergency Contact:

  • Ico multiline

    University and College Affiliation:

  • Ico multiline

    Professional Affiliations:

  • Ico statictext

    I have read and understand these policies.

  • Ico textbox

    Client

  • Ico date

    Date

  • Ico signature

    Client Signature

  • Ico textbox

    Parent name (If client is a minor)

  • Ico date

    Date

  • Ico signature

    Parent Signature

  • ...and More!

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