Confidentiality Agreement Consent Form

Trust & confidentiality are two terms which hold a lot of value when it comes to a legal situation. Most of the time it holds good, in a number of medical situation where confidentiality is a must. For instance, if a person is going through psychiatric treatments post a trauma, it is of utmost importance that all these sessions must be held in confidence, and the personal topics will never be disclosed without permission from the patient.

For this purpose, a confidentiality agreement consent form needs to be signed by the both parties where the physician promises to keep all the information as discussed between them confidential. It has to be clearly mentioned in words that keeping in mind the trust and respect that is the building stone of a relationship between a therapist and the patient, all the information as disclosed in the session, be it written or verbal, will be kept confidential under all circumstances.

Instances of exceptions might spring up, hence these needs to be clearly mentioned in the form as well. Some common exception are, if the patient is capable of hurting oneself, then the therapist can go ahead and call for help and disclose the confidential information. Lastly both the parties need to sign the form.

Sample Confidentiality Agreement Consent Form

Confidential Form


Category: Consent Forms

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