The informed-consent form for therapy in India: what to include, and a template

By Sadique Ali, Glyphora, maker of Psyledger8 September 202611 min read

Most consent forms in Indian practice are one of two things. Either a single line on the intake sheet, "I agree to counselling", or five pages copied from an American template, complete with a paragraph about HIPAA. Neither does the job. A consent form is the record of a conversation, and its purpose is that the client understands what therapy is and is not, what you will keep private and when you cannot, what it costs, and what they can do if something goes wrong.

This guide is for clinical and counselling psychologists and counsellors in private practice in India. It sets out what the law and the professional codes actually ask for, the eleven things a good form covers, how to take consent so that it means something, and the differences for minors, couples and online sessions. A template you can adapt is at the end. It is not legal advice; where your practice is unusual, have counsel read your form once.

What consent means here

The Mental Healthcare Act, 2017 gives India a definition worth reading in full, because it is the standard a court or a regulator will reach for. Informed consent, in the Act's words, is consent given for a specific intervention, without force, undue influence, fraud, threat, mistake or misrepresentation, and obtained after adequate information has been disclosed, including the risks, benefits and alternatives of that intervention, in a language and manner the person understands.

Four things follow from that sentence. Consent is for a specific intervention, so agreeing to "counselling" in general is thin. It has to be informed, so there is something to explain before there is anything to sign. It has to be understood, which is a point about language and literacy, not paperwork. And it has to be free, which matters when the person paying is a parent or an employer rather than the client.

The Act's idea of a mental health professional includes clinical psychologists registered with the state authority. Counsellors outside that definition are not bound by it directly, but its standard of consent is the one everyone is measured against, and the Rehabilitation Council of India's conduct norms and the professional associations' ethics codes say the same thing in fewer words: explain, agree, record.

One more thing sits alongside treatment consent and is often confused with it. Under the Digital Personal Data Protection Act, a client also consents to your processing their data, after a notice that says what you keep and why. That is a different consent, and it should stand apart on the form so that either can be withdrawn on its own. A client can stop therapy and still want their records kept; a client can ask for their data to be erased while continuing to attend. Our guide to the DPDP Act covers the data side; this one is about the treatment.

The eleven parts of a good form

A form that covers these, in this order, in plain language, on two pages, is better than most in use today.

1. Who you are

Your name, qualification, registration number where you have one, and how to reach you. A client should be able to check you exist.

2. What therapy is, and is not

Your approach in a sentence, how long a session lasts, how often you meet, roughly how many sessions a first piece of work takes, and that this can change. Say that therapy can be uncomfortable before it helps, that outcomes are not guaranteed, and that you are not a substitute for psychiatric care where medication or admission is needed.

3. Confidentiality, and exactly when it ends

This is the section clients read most closely, and the one most forms get wrong by importing another country's list. In India the honest list is:

• Risk of serious harm. If you believe the client is at imminent risk of harming themselves or someone else, you may contact their emergency contact or the emergency services, and you will tell the client you are doing so where you can.
• A child at risk. The Protection of Children from Sexual Offences Act places a duty on any person who knows of, or has reason to believe, a sexual offence against a child to report it, and makes failure to report an offence. A therapist has no exemption. Say this plainly, because it is the limit that most surprises clients, and because it applies whether the child is the client or a child the client mentions.
• A court or a legal process. A court can order the production of records or your testimony. You will resist disclosure beyond what is ordered, and you will tell the client where the law allows.
• Other professionals treating the same person. With the client's agreement, and only what they need.
• Supervision and consultation. You discuss your work with a supervisor or peers with identifying details removed. Every good clinician does; the form should say so.
• The Mental Healthcare Act's own exceptions, which include a nominated representative who needs information to act for the client, and the protection of others from harm.

Everything else stays in the room. Say that too, because the list of exceptions reads as frightening until the rule is stated beside it.

4. Records

What you keep (session notes, assessment results, invoices, contact details), where (in a system with a login, not on paper in a drawer or in a chat app), for how long (your written retention period), and who can see it (only you, unless the client asks you to share). Say that the client can ask for a summary of what you hold, and that a signed clinical note is kept even if they ask for erasure, because your professional duty requires it. Point to your privacy notice for the rest.

5. Fees, payment and cancellation

The fee per session, whether GST applies, how to pay, and when. The cancellation window, in hours, and what a late cancellation or a no-show costs. Whether you offer a reduced fee and on what basis. A fee dispute is the commonest reason a therapeutic relationship sours, and the form is where you prevent it.

6. Contact between sessions, and emergencies

Which channels you use (email, a phone number, a booking link), how quickly you reply, and that messages are not read at night or on days off. Then the sentence every Indian form needs: if you are in crisis, do not wait for me to reply; call Tele-MANAS on 14416, go to the nearest emergency department, or call the person you named as your emergency contact. Take the name and number of that emergency contact on the form.

7. Online sessions

If you see clients on video, add: which platform, that the client should be somewhere private, that you need to know the city they are in for that session in case of an emergency, that you will confirm identity at the first session, what happens if the connection drops, and that neither side records. The NIMHANS telepsychotherapy guidelines of 2020 ask for exactly these, and they are good practice regardless.

8. Minors

For a client under eighteen, the parent or lawful guardian consents and the young person gives their assent. Both should hear the limits of confidentiality. Say what the guardian will be told (attendance, safety concerns, the general direction of the work) and what they will not (the content of sessions), because an adolescent who believes everything is relayed home will say nothing useful. More on this below.

9. Couples and families

Who the client is (the couple, not either partner), what happens if one partner asks for an individual session, and your policy on secrets: most therapists tell couples that anything said to the therapist alone may be brought into the joint work, so that the therapist is not holding a secret against one partner.

10. Recording, teaching and research

A separate opt-in, never bundled. Most clients will say yes to anonymised case discussion in supervision and no to a recording, and they should be able to say each on its own.

11. Rights

To ask anything, to refuse any part of the work, to stop at any time without explanation, to ask for a referral or a second opinion, and to complain: to you first, and then to the body you are registered with. Name it.

Close with the signature block: the client's name, signature and date; yours; the version of the form and its date; and, for a minor, the guardian's name, relationship and signature.

How to take consent so it means something

Talk first, then sign. Go through the form in the first session, aloud, before anything else. It takes ten minutes and it is the first piece of therapy: the client learns that you explain things and that they can ask. A form emailed in advance to read is fine as preparation, never as a substitute.

Use their language. The Act says "a language and manner understood by the person" for a reason. If you practise in Kerala, have a Malayalam version; if a client reads with difficulty, read it to them and note that you did. A translation checked by a colleague is enough; it does not need a lawyer.

Keep it out of the intake sheet. Consent buried among the questions about sleep and appetite is not the clear, specific act the law describes.

Version it. Put a version number and a date on the form. When you change the wording, ask existing clients again at their next session and record which version each client agreed to and when. If a dispute arises two years later, "she signed version 3 on 14 March" is an answer; "she signed something" is not.

Renew it when the plan changes. Consent to talk is not consent to a psychometric assessment, to a letter to an employer, to involving a spouse, or to a shift to online sessions. Each of those is a short conversation and a line in the note: discussed, agreed, date.

Write one line in the record. "Consent discussed; questions about confidentiality and the POCSO duty answered; form v3 signed." That line is worth more than the signature.

Minors, separated parents, and adults who cannot consent

A person under eighteen cannot give consent on their own, so a parent or lawful guardian does. Take the guardian's name, relationship and signature, and give the young person a real say: explain the work, ask whether they agree, and write down that you did. An adolescent who is brought unwillingly can still be seen, but the form and the note should be honest about who wanted the therapy.

Where parents are separated, ask who has custody and guardianship before the first session, and follow any court order. Where both parents are involved and available, get both signatures; where only one is, note why. A parent who was not told and later objects is a complaint you can avoid with one question at booking.

For an adult who cannot consent, during a severe episode for instance, the Mental Healthcare Act's provisions on nominated representatives and advance directives apply, and a psychiatrist is almost always involved. That is beyond what a counselling practice's consent form can carry; refer, and record the referral.

The template

Adapt this to your practice, read it with each client, and keep the version each one signed. Square brackets mark what you fill in.

Consent to psychological services

Version [3], dated [1 September 2026]

About me. I am [name], a [clinical psychologist / counselling psychologist / counsellor], [qualification], registered with [body] under number [number]. You can reach me at [email] and [phone].

What we will do. I work mainly with [approach, in one sentence]. Sessions last [50] minutes and are usually [weekly]. A first piece of work often takes [8 to 12] sessions, and we will review progress together at around session [6]. Therapy can be uncomfortable before it helps, and I cannot promise a particular outcome. I am not a substitute for psychiatric care; if medication or admission may be needed, I will say so and help you find it.

Confidentiality. What you tell me stays between us, with these exceptions, which the law or my duty of care requires: (1) if I believe you are at imminent risk of serious harm to yourself or someone else, I may contact your emergency contact or the emergency services, and will tell you where I can; (2) if I learn that a child has been, or is at risk of being, sexually abused, I am required by law to report it; (3) if a court orders me to disclose records or give evidence, I will disclose only what is ordered; (4) with your agreement, I may share what another professional treating you needs; (5) I discuss my work with a supervisor and peers without identifying you.

Your records. I keep session notes, assessment results, invoices and your contact details in a secure system that only I can open. I keep clinical records for [seven] years after our work ends, and financial records for [eight]. You may ask me for a summary of what I hold. A signed note is kept even if you ask for other data to be erased, because my professional duty requires it. My privacy notice, at [link], says more. Separately from this form, you agree to my processing your personal data as that notice describes: [ ] Yes

Fees. [₹ amount] per session, payable [before or at the session] by [UPI / card / cash]. [GST does not apply / GST applies at 18%.] If you cancel with less than [24] hours' notice, or do not attend, the full fee is charged, except in an emergency.

Contact between sessions. Email me at [email] or message [number]; I reply within [one working day], not at night or on [day]. If you are in crisis, do not wait for me: call Tele-MANAS on 14416, go to the nearest emergency department, or call your emergency contact.

Emergency contact: [name], [relationship], [phone].

Online sessions (if we meet by video). We use [platform]. Please join from a private place, with headphones if others are nearby. At the start of each online session I will ask which city you are in, so that I can direct help there in an emergency. Neither of us records sessions. If the connection drops, I will call you on [number].

Recording, teaching and research. I may discuss our work, without your name or identifying details, in supervision: [ ] Yes [ ] No. I may record sessions for [purpose]: [ ] Yes [ ] No. Each can be withdrawn at any time.

Your rights. You may ask me anything about this work, refuse any part of it, stop at any time without giving a reason, and ask for a referral or a second opinion. If you are unhappy with my conduct, tell me; you may also complain to [body and contact].

Client: [name] · signature · date

Clinician: [name] · signature · date

For a client under 18. I, [guardian's name], [relationship], consent to the above on behalf of [client's name], and I understand what I will and will not be told about the sessions. Signature · date. The young person's assent: [name] · signature · date.

For couples, add one paragraph naming the couple as the client and stating your policy on individual sessions and secrets, and take both signatures.

Where software helps

The conversation above cannot be automated, and should not be. What software can do is stop the paperwork from decaying: show the current consent wording to a client before their first appointment is confirmed rather than after, keep every version with the date and time each client agreed, ask a guardian for consent when a booking says the client is a minor, and ask again when the wording changes. Psyledger does those things, with the treatment consent and the data consent recorded separately, which is what lets you answer "which version did she agree to, and when?" without a filing cabinet. The ten minutes of explanation in the first session remain yours.

Sources: the Mental Healthcare Act, 2017 (definition of informed consent; the right to confidentiality and its exceptions; nominated representatives and advance directives); the Protection of Children from Sexual Offences Act, 2012 (the duty to report and the penalty for failing to); the Digital Personal Data Protection Act, 2023 (consent and notice); the NIMHANS guidelines for telepsychotherapy services, 2020; the Rehabilitation Council of India's professional conduct norms. This guide describes the law in general terms and is not legal advice for any particular practice.