Client Consent Form Generator

A ready-to-print informed consent form built around Indian practice norms. Toggle clauses on or off, add your own, sign, download.

Your practice

Practice name *

Practitioner name

Phone

Practice address

Client

Client name *

Date of birth

Parent / Guardian (if minor)

Client address

Clauses to include

Uncheck any clause you don't want. All are pre-written for Indian practitioners.

Nature of Services

I understand that the services provided are professional in nature and are not a substitute for emergency medical or psychiatric care. In case of a crisis, I will contact emergency services (112) or a nearby hospital.

Confidentiality

Information shared during sessions is confidential and will not be disclosed without written consent, except: (a) when there is risk of harm to self or others, (b) when required by law or court order, (c) in case of suspected abuse of a minor or vulnerable adult.

Records & Storage

Notes and records related to my sessions will be stored securely and retained as per applicable Indian data protection guidelines. I have the right to request a summary of my records.

Fees & Cancellation

I agree to the fees quoted at the time of booking. Cancellations made less than 24 hours before the session may be charged in full at the practitioner's discretion.

Digital/Online Sessions

For online sessions, I acknowledge the risks of technology (connectivity issues, potential breach) and agree to use a private, secure environment during sessions.

Consent for Minors (if applicable)

If the client is under 18, I confirm that I am the parent or legal guardian and grant consent for the services described.

Right to Withdraw

I understand that I may withdraw consent and discontinue services at any time by providing written notice to the practitioner.

Additional notes (optional)

Signature

Signatory name

Date

Download

Clauses selected: 7

Nothing is saved to any server.

What is a client consent form?

An informed consent form is a written agreement between a practitioner and client that describes the nature of services, confidentiality boundaries, fees, and rights. Under India's IT Act and evolving personal data protection guidelines, having a signed consent on file protects both parties and clarifies expectations.

This template is drafted for common practice types — therapy, counselling, coaching, nutrition, and wellness. Adapt it to your specific specialisation, and consider legal review if you serve regulated populations.