We’ve created a sample client consent form you can use as a starting point when introducing Blueprint to your clients.

You’ll find the full text of the consent form below, along with a downloadable version you can copy, edit, and share: Client Consent Template

This template is meant as a general reference. Feel free to customize it to fit your practice’s needs, and consult with legal counsel if needed.

Your clinician has opted to use Blueprint’s note-taking system as part of their effort to provide excellent care to clients. Blueprint’s note-taker temporarily records sessions and uses this recording to automatically generate a progress note (a required form of clinical documentation). After a progress note is generated, the recording is automatically deleted from Blueprint’s servers and database.

Use of this technology allows your therapist to be fully present during your sessions, without having to slow down to take notes or trying to remember important information during the session. This allows them to focus all of their attention on your care.

Blueprint’s software is HIPAA compliant and SOC 2 Type 2 certified, which means an external third-party auditor reviews Blueprint’s systems, policies, and processes on an ongoing annual basis to ensure Blueprint meets certain data privacy and security standards.

By signing this consent form, you are agreeing to allow your clinician to record your sessions and utilize software to assist them in generating progress notes to document these encounters.

Name: ___________________________

Signature: _______________________

Date: ____________________________