An informed consent form covers disclosure requirements. A client agreement protects your business. Most private practice therapists conflate the two or skip the business side entirely — and then face problems around no-shows, non-payment, or scope disputes that a clear agreement would have prevented.
Informed consent vs client agreement: what each covers
Informed consent is a clinical and legal requirement — it documents that the client understands the nature of therapy, your credentials, the limits of confidentiality, and their right to terminate. It is not optional, and most licensing boards prescribe what it must include.
A client agreement (sometimes called a practice policies form) covers the business relationship: fees, payment timing, cancellation policy, telehealth rules, social media policy, and what happens if a client owes a balance. The two documents serve different purposes and you likely need both.
What every therapy client agreement must include
- Session fee and payment schedule — exact rate, when payment is due, accepted methods
- Cancellation and no-show policy — your window, the fee for late cancellation, exceptions
- Late payment policy — what happens to unpaid balances, when you pause scheduling
- Telehealth expectations — platform used, client location requirements, tech failure protocol
- After-hours contact — how to reach you between sessions, what constitutes a crisis
- Social media and dual relationship policy — whether you connect on social media, how to handle chance in-person contact
- Termination policy — under what circumstances you or the client may end therapy and how
- Release of records — what is required to request documentation
Writing a cancellation policy that actually protects you
A 24-hour cancellation policy with a fee equal to your full session rate is standard. Some therapists charge 50% for late cancels; some charge full fee for no-shows only. The key is that the policy is written clearly, explained at intake, and enforced consistently — inconsistent enforcement signals that the policy is not real.
Many therapists feel uncomfortable enforcing cancellation fees with long-term clients. Building it into your intake agreement — and a card-on-file payment system — makes the conversation much easier. The charge happens automatically; you are simply following the agreement you both signed.
Get your forms reviewed by an attorney once
A one-time review by a healthcare attorney costs a few hundred dollars and is worth every cent. Template forms from professional associations are a starting point, but they may not reflect your state's requirements or your specific practice structure. You will use these forms with every client for years — having them properly drafted is not a luxury.
How to collect forms before the first session
Send forms immediately after a client books. Use a HIPAA-compliant e-signature tool — not an email attachment. Make completion of intake forms a condition of the first appointment. Clients who do not complete intake paperwork often do not show up for the first session either; it is a useful filter.
Tracking which prospects have completed intake, which have outstanding forms, and which have not yet signed can be managed manually when you have a handful of clients. At a full caseload with a waitlist, a tool like Threecus keeps everything visible so nothing slips. See our guide to managing therapy clients in private practice without burning out.
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