A Free, Editable Electronic Communication Consent Form

Request for Non-Secure Communication Form (Email, Texting, etc.)

Before using this form, be sure to at least read these articles (although some coursework or consultation on the related risk management issues would be most appropriate):

 

There are nuances to using this, and those nuances are more deeply covered in our online CE courses here: Digital Confidentiality Course Series. We strongly recommend researching and learning about the issues surrounding use of email and texting before using these media with clients.

secure communication form
v1.1.6

Scheduled Maintenance

We will be temporarily taking the website offline at 10:00 PM Pacific (1:00 AM Eastern) tonight, July 6, in order to make some improvements. We plan to be back online by midnight Pacific (3:00 AM Eastern). We apologize for any inconvenience this may cause. Dismiss