Art Therapy Telehealth Consent Form
Client Name
Date of Birth
Email
Telehealth Services Summary
Confidentiality
Risks and Benefits
Emergency Procedures
Technology Requirements
Fee & Payment Policy
Consent
I have read and understand the information above.
I consent to participate in telehealth art therapy services.
Client Signature
Date
Parent/Guardian Consent (if under 18)
Parent/Guardian Name
Parent/Guardian Signature
Date