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Adolescent Informed Consent Form - The PSYCH Group, LLC

Adolescent Informed Consent Form - The PSYCH Group, LLC 2026

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The document is an Adolescent Informed Consent Form from The PSYCH Group, LLC, outlining the privacy policies and confidentiality rules regarding counseling and therapy for adolescents. It explains the importance of confidentiality, the circumstances under which information may be disclosed (such as threats of harm or abuse), and the communication protocols with parents, guardians, schools, and doctors. The form requires signatures from both the adolescent and their parent/guardian to acknowledge understanding of these policies.

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Click ‘Get Form’ to open it in the editor.
Begin by reading the introductory section carefully. This outlines what to expect during your counseling sessions and emphasizes the importance of confidentiality.
Fill in the minor’s signature and date at the bottom of the form, indicating that you understand the policies regarding privacy and confidentiality.
Next, move to the parent/guardian section. Check the boxes that indicate your agreement with each statement regarding respect for your adolescent's privacy.
Finally, both parents/guardians should sign and date where indicated, confirming their understanding and agreement with the outlined policies.

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