Establishing an Ethical Therapy Practice: Intake Form Templates

Whether you're just getting started or manage a well-established practice, running an ethical practice is always a top-of-mind concern. However, between state requirements, HIPAA regulations, and your drive to provide the best care possible, navigating the inky waters of documentation and regulation can seem like a chore. When you're just getting started, you can easily build your practice on an ethical foundation by creating intake forms to share with future clients.

Ethical practice guidelines

Kicking off the Client/Therapist Relationship

For many practices, the first step to accepting a new client is understanding if you are a good fit for one another. You may perform an assessment to understand a potential client's needs and determine you're equipped to help. From this point forward, you move into a client/therapist relationship. It is your responsibility, as the therapist in this relationship, to set boundaries and expectations.

To accomplish this goal, you should provide intake documents to your new client. It is our view that the following documents are the foundation of an ethical practice. They include the Informed Consent Form, the HIPAA Notice of Privacy Practices, and the Consent to Electronic Communications. To get you started, we've described each of these below and included a template you can personalize of each.

The Informed Consent

The Informed Consent is a foundational practice document that helps set those boundaries and expectations. It also ensures both parties are aware of and understand the care relationship. Just a few examples of discussion points it could cover include: outcomes, contact methods, your fees, limits to confidentiality, and any policies surrounding cancellations.

Depending on your state's requirements, you may need to include additional notices in your Informed Consent. To learn any notices your state requires, you should check with your state licensing board, a state professional organization you're a member of, or even a trusted mentor. 

For a free sample Informed Consent form, simply click to download a copy below. You'll need to read through the entire document to ensure your practice's policies are accurately portrayed. Be sure to update any fields in [highlighted brackets] to reflect your practice's specific information.

A note on insurance: If you only accepting private pay or self-pay, you will need to delete section "IV. Insurance".

 

Click here for your free Informed Consent Template!

**This Informed Consent was originally created by our partners at The Center for Ethical Practice and used with permission.

 

The HIPAA Notice of Privacy Practices

The HIPAA Notice of Privacy Practices is a document that notifies clients' of their rights to their information. Relationships with clients are best built on the foundation of transparency, and this document facilitates transparency while detailing your use of client information. It's required by HIPAA regulations for any "Covered Entity."

Covered entity rules and laws change often and vary from state to state. To learn more about covered entities and determine if your practice is covered, read more here. That said, knowing whether you're a covered entity or not can be tricky. If you're struggling, this article from our friends at Person Centered Tech can shed light on the issue.

**We always recommend a conversation with a qualified healthcare attorney to ensure you are taking the necessary steps to protect your practice. This information does not qualify as legal advice.**

For a free sample HIPAA Notice of Privacy Practices form, simply click to download a copy below. Please read through the entire document to ensure your practice's policies are accurately portrayed. Then, be sure to update any fields in [highlighted brackets] to reflect your practice's practice.


Click here for your free Authoriztion for Electonic Consent Template!
**This HIPAA Notice of Privacy Practices was originally created by our partners at Quirktree and used with permission.
 

 

The Consent to (Authorization for) Electronic Communications

The Authorization for (or Consent to) Electronic Communications is a vital part of your intake package, as it facilitates communication between you and your client.

This document meets the standards detailed by the various industry codes of ethics: the AMA Code of Medical Ethics, the ACA Code of Ethics, and the APA Code of Ethics. It also fulfills the requirements provided within HHS's 2013 HIPAA Omnibus Rule.

You do have the option of eschewing all versions of electronic communications making phone calls and sending letters only to avoid this additional layer of complexity; Before making that trade-off, it's worth considering the value you get from electronic communication tools. Do they improve your ability to provide care? If so, you'll want to think carefully about the impact to your client's care. Plus, there are tools that improve your client's ability to effectively communicate with you. For example, HIPAA-compliant appointment reminders and messaging are both features of TherapyAppointment and make it easy to honor HHS and industry standards. Text messages are a popular tool to communicate with clients, as well. If you are curious to learn more about HIPAA's stance on text messaging, this article is a great resource.

For a free sample Authorization for Electronic Communications form, simply click to download a copy below. Be sure to update any fields in yellow to reflect your practice's name and read through the entire document to ensure your practice's policies are accurately portrayed.


Click here for your free Authoriztion for Electonic Consent Template!
**This Authorization for Electronic Communications was originally created by our partners at Quirktree and used with permission.

 

The Necessity of an Ethical Practice

If you're reading this article, you're already taking the first steps to ensure that your practice is following industry and regulatory guidelines for an ethical practice. Download and customize any or all of the forms we've published here, and feel free to share them with your colleagues. Our goal is helping the mental health therapist community thrive and grow, and we want to ensure you have everything you need!

That said, this post in no way constitutes legal advice. We highly recommend your practice employs a trained healthcare attorney to advise on any HIPAA related issues or questions.

 


 

Disclaimer

It is the reader's sole responsibility to ensure the information included in these forms meets the requirements of your state.

It is also the reader's responsibility to ensure these forms are adapted to any practice-specific policies. Please read through the forms and update any highlighted generalized fields to ensure the version you use represents your practice.