Virtual Therapy Client Communication Consent Form

Client Information

Full Name Date of Birth Email Phone Number

Consent for Virtual Communication

I consent to engaging in virtual therapy sessions using electronic communication.

I understand the risks of communicating via email and consent to its use when necessary.

I understand the risks of communicating via text/SMS and consent to its use when necessary.

I understand the risks of communicating via phone and consent to its use when necessary.

Confidentiality & Privacy

Technology & Security

Client Acknowledgement

Questions/Comments