Recording Consent  ·  New

Record Counseling Sessions with Clear Client Consent

Therapists and counselors can document client permission to record sessions, limit how recordings are used, and note guardian details for minors.

Jade theme
formbuilder.ai/f/counseling-session-audio-video-recording-consent-form
Counseling Session Audio & Video Recording Consent Form
Client Full Name
· · ·
Client Date of Birth
· · ·
Email Address
· · ·
Submit

This counseling session recording consent form gives therapists, counselors, and clinical practices a clear, professional way to get written permission before recording client sessions. Clients enter their name, date of birth, and contact details, identify their counselor and any clinical supervisor, and then specify exactly what they are authorizing. This includes the type of recording, which sessions the consent covers, an optional consent period, and the permitted uses of their recordings. A deletion preference and an open field for restrictions, such as topics that should not be recorded or camera angle preferences, let clients set boundaries that fit their comfort level.

The template is ideal for licensed counselors, psychotherapists, social workers, counseling interns, graduate training programs, and group practices that record sessions for clinical supervision, training, or quality assurance. A dedicated section outlines the client's rights regarding session recordings. It confirms that clients may ask to pause or stop recording at any time and may revoke consent in writing without any effect on their counseling services. For clients under 18, a parent or legal guardian can be named. The signing date is captured alongside a final acknowledgment that the client has read the form and voluntarily authorizes the selected recordings and uses.

Using a structured online consent form helps you set clear expectations, respect client autonomy, and keep consistent documentation for your records. Rather than chasing paper forms, you can share the form with clients before any session is recorded and collect responses digitally. You can also customize the wording, permitted uses, and retention options to align with your practice policies, ethical guidelines, and applicable legal requirements.

3 Pages
18 Questions
~6min To complete
Free No credit card needed
Field types Full Name ×4 Date ×2 Single Choice ×2 Email Phone daterange choicematrix Dropdown Long Text richtext singlecheckbox termsandconditions Signature

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Client & Counselor Information 6 questions
Client & Counselor Information
1 Client Full Name * Full Name
2 Client Date of Birth * Date
3 Email Address * Email
4 Phone Number Phone
5 Counselor / Therapist Name * Full Name
6 Clinical Supervisor Name (if applicable) Full Name
Page 2 Recording Details & Permissions 6 questions
Recording Details & Permissions
1 Type of Recording Authorized * Single Choice
2 This Consent Applies To * Single Choice
3 Consent Period (if a specific date range was selected) daterange
4 Permitted Uses of Your Recordings * choicematrix
5 Recording Deletion Preference * Dropdown
6 Restrictions or Special Requests (e.g., topics not to be recorded or camera angle preferences) Long Text
Page 3 Your Rights & Authorization 6 questions
Your Rights & Authorization
1 Your Rights Regarding Session Recordings richtext
2 I understand I may ask to pause or stop recording at any time and may revoke this consent in writing without any effect on my counseling services. * singlecheckbox
3 Parent / Legal Guardian Name (if client is under 18) Full Name
4 Date Signed * Date
5 I have read and understand this consent form, have had the opportunity to ask questions, and voluntarily authorize the recording and uses I selected above. * termsandconditions
6 Client Signature (or Parent/Legal Guardian if client is under 18) * Signature

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.

  • Ready-to-use structure — pre-configured fields out of the box
  • Applied "Jade" theme — fonts, colors, and layout already set
  • Mobile-responsive — works on every device without extra configuration
  • Fully editable with drag-and-drop — change anything in seconds
  • Free to use on any plan, no credit card required

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Category Consent & Waiver
Subcategory Recording Consent
Theme Jade
Badge New
Price Free
Coding required None

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