Consent to Audio Recording by Therapist

InMindOut Emotional Wellness Center, LLC is committed to the education and training of therapists in
mental health. As such, 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 of therapists and to ensure
best quality of services.


  • I consent to be audio recorded for the purposes of supervision, training, and education of
  • I understand that the audio recording(s) of sessions are to be used for training and education
    purposes only.
  • I understand that I can terminate this agreement at anytime.


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


Leave this empty:

InMindOut Emotional Wellness Center
Signature Certificate
Document name: Consent to Audio Recording by Therapist
Unique Document ID: 81f8ee4bc85ca72d5db900341a6cd7ecfd1bdbf0
Timestamp Audit
October 17, 2017 9:09 am CDTConsent to Audio Recording by Therapist Uploaded by Amanda Bergeron Bergeron - IP
January 18, 2018 10:00 am CDT Document owner has handed over this document to 2018-01-18 10:00:17 -