Consent to Audio Recording by Postdoctoral Fellow

At InMindOut Emotional Wellness Center, LLC, we are continuing to find ways to improve our
supervision and training. One way to do this is to audio record therapy sessions to assist in supervision
and to ensure best quality of services. Upon completion of Postdoctoral Fellow’s 1-2 year rotation,
audio records of therapy sessions will be deleted, unless otherwise specified, or upon written request
from the client being seen by the Postdoctoral Fellow. I understand that I can terminate this agreement
at anytime.


  • I consent to be audio recorded for the purposes of supervision of the Postdoctoral Fellow.


If client is a minor, please have the parent or legal guardian sign this form.

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InMindOut Emotional Wellness Center
Signature Certificate
Document name: Consent to Audio Recording by Postdoctoral Fellow
Unique Document ID: 0604bdc5b899ede8bc442576392ec248bd745941
Timestamp Audit
October 17, 2017 2:53 pm CDTConsent to Audio Recording by Postdoctoral Fellow Uploaded by Amanda Bergeron Bergeron - IP