Telehealth Informed Consent: What Needs to Be Included?
Many therapists understand that telehealth informed consent is an important part of ethical and legally compliant practice. The challenge is often determining what information should actually be included in the consent process. Questions about privacy, technology, emergencies, communication, documentation, and client location can quickly make telehealth informed consent feel more complicated than traditional in-person consent discussions.
Part of the confusion is that telehealth introduces considerations that may not arise in the same way during in-person treatment. Clinicians must think about technology platforms, data security, emergency procedures, interstate practice issues, and how services will be delivered when therapist and client are not physically in the same location. As telehealth continues to evolve, many therapists want to make sure their informed consent process reflects current ethical, legal, and professional expectations.
What I want to do here is review the major areas commonly addressed in telehealth informed consent and discuss how these topics fit into broader telehealth practice.
What Needs to Be Included in Telehealth Informed Consent?
If you're reviewing your telehealth informed consent process, the next step often depends on which areas need clarification:
• If you're concerned about privacy and confidentiality → review how technology, communication, and data security are addressed.
• If you're unsure how to handle emergencies → review emergency planning, local resources, and client location procedures.
• If clients travel or relocate → review jurisdictional considerations and location verification procedures.
• If you're using electronic communication → review messaging, email, texting, and response-time expectations.
• If you're unsure whether your informed consent process is comprehensive → review the major categories commonly addressed in telehealth practice.
Why Telehealth Informed Consent Is Different
Telehealth informed consent builds upon the same ethical principles that guide informed consent in traditional therapy. Clients should understand the nature of services being provided, the potential risks and benefits of treatment, available alternatives, confidentiality considerations, and their rights as participants in treatment. These foundational principles remain important regardless of whether services are delivered in person or remotely.
Telehealth introduces additional considerations because technology becomes part of the treatment environment. Clinicians must consider how services will be delivered, what happens if technology fails, how privacy will be protected, where clients are physically located during sessions, and how emergencies will be handled when therapist and client may be in different communities or even different states.
As telehealth has become more common, informed consent discussions have expanded to address these practical realities. Many therapists find it helpful to think about telehealth informed consent as a conversation that helps clients understand not only the therapy process itself, but also how technology, communication, privacy, and safety considerations affect the delivery of care.
Privacy, Confidentiality, and Technology Considerations
Privacy and confidentiality are often among the first topics clinicians think about when developing a telehealth informed consent process. While confidentiality remains a core component of therapy regardless of the treatment setting, telehealth introduces additional considerations related to technology platforms, electronic communication, data storage, and information security.
Clients benefit from understanding what technology will be used for services, how information is protected, and what steps are being taken to safeguard confidentiality. Discussions may include the telehealth platform being used, data encryption, record storage procedures, third-party vendors, and any limitations associated with technology-based communication. Clients may also benefit from understanding their own role in protecting privacy by participating in sessions from a private location and using secure devices and internet connections when possible.
Technology can also create risks that may not exist in traditional office-based treatment. Internet disruptions, software failures, security breaches, and communication difficulties can all affect service delivery. Addressing these possibilities during informed consent helps clients understand how such situations will be managed if they occur.
Emergency Planning and Client Location
Emergency planning is another area that frequently receives special attention in telehealth informed consent. When therapist and client are not physically located in the same place, responding to emergencies may require additional planning and coordination.
Many clinicians develop procedures for obtaining and documenting a client's location at the beginning of each session, maintaining updated emergency contact information, and identifying local emergency resources that may be needed if a crisis occurs. These procedures help ensure that clinicians can respond appropriately if safety concerns arise during treatment.
Client location can also affect legal and regulatory considerations. Telehealth services are generally governed by the laws and regulations of the jurisdiction where the client is physically located at the time of service. As a result, informed consent discussions often include expectations regarding travel, relocation, and the importance of notifying the provider when location changes occur.
Discussing these issues in advance can help reduce confusion and ensure that both therapist and client understand how emergencies, travel, and jurisdictional considerations will be managed throughout treatment.
Communication Expectations and Documentation
Telehealth informed consent often includes discussion of how communication will occur both during and between sessions. Clients may have questions about whether email, text messaging, patient portals, phone calls, or other communication methods can be used and what limitations may apply to those methods.
Many clinicians find it helpful to establish clear expectations regarding approved communication channels, expected response times, and appropriate uses for various forms of communication. These conversations can help reduce misunderstandings and provide clients with realistic expectations about how and when communication will occur.
Documentation considerations are also commonly addressed. Clinicians may discuss how informed consent will be documented, how records are maintained, how telehealth sessions are documented, and whether any recordings will occur. When recordings are used, informed consent discussions often address storage, access, retention, and destruction procedures.
Clear communication and documentation practices can support transparency, reduce confusion, and help establish a shared understanding of how telehealth services will be delivered.
Informed Consent Is an Ongoing Process
Many therapists view informed consent as a document that is signed at the beginning of treatment and then placed in the clinical record. In practice, informed consent often functions as an ongoing process that evolves as treatment progresses.
Technology platforms may change. Clients may relocate, travel, or begin attending sessions from new locations. New communication methods may be introduced. Changes in privacy practices, legal requirements, or clinical circumstances may also require additional discussion and documentation.
For these reasons, many clinicians revisit informed consent periodically throughout treatment. Reviewing important topics, answering questions, and documenting significant changes can help ensure that clients continue to understand how services are being provided and what expectations apply to the therapeutic relationship.
At this point, many clinicians understand the major categories that belong in telehealth informed consent but would benefit from a structured way to review their own procedures. The free Telehealth Informed Consent Checklist provides a comprehensive framework for reviewing provider information, risks and benefits, privacy and security practices, emergency procedures, communication expectations, jurisdictional considerations, documentation requirements, and other commonly addressed informed consent topics.
→ Telehealth Informed Consent Checklist (free)
Beyond Informed Consent
A comprehensive informed consent process is an important component of telehealth practice, but it represents only one area clinicians may need to evaluate. Providing telehealth services also involves questions about competence, documentation, data security, emergency preparedness, interjurisdictional practice, assessment procedures, supervision, and emerging technologies.
As telehealth becomes increasingly integrated into clinical practice, therapists often find themselves evaluating whether their policies, procedures, and professional competencies continue to align with evolving standards and expectations. Questions that initially begin with informed consent frequently expand into broader discussions about telehealth practice as a whole.
Many clinicians find it helpful to periodically review their telehealth practices using a structured framework that extends beyond informed consent alone. The free Telepsychology Competency Audit Checklist was developed to help clinicians evaluate key areas of telehealth competence, including informed consent, data security, documentation, emergency planning, interjurisdictional practice, assessment considerations, supervision, and emerging technologies. It can serve as a practical self-assessment tool for identifying strengths, gaps, and areas for continued professional development.
→ Telepsychology Competency Audit Checklist (free)
Building a Broader Framework for Telehealth Practice
Telehealth continues to evolve alongside changes in technology, privacy standards, interstate practice regulations, documentation expectations, artificial intelligence, and emerging clinical tools. As a result, many clinicians find themselves navigating questions that extend far beyond informed consent alone.
Developing confidence in telehealth practice often involves building a broader understanding of how legal, ethical, clinical, and technological considerations interact. Rather than focusing on isolated requirements, clinicians can benefit from understanding the larger framework that supports ethical and compliant telehealth service delivery.
Additional resources on telehealth law, ethics, privacy, documentation, artificial intelligence, interstate practice, and compliance topics are available through the Law & Ethics Hub. For clinicians seeking a more structured and comprehensive learning experience, continuing education can provide a deeper exploration of these issues and their practical application in clinical practice.
The Telehealth: Efficacy, Laws & Ethics CE course was developed for clinicians who want a comprehensive understanding of telehealth practice, including informed consent, privacy and confidentiality, jurisdictional considerations, documentation requirements, emergency planning, telehealth efficacy research, emerging technologies, and ethical decision-making. The course is self-paced and eligible for continuing education credit, allowing clinicians to build practical skills they can apply immediately in practice.
→ Telehealth: Efficacy, Laws & Ethics CE
Conclusion
Telehealth informed consent often includes much more than obtaining permission to conduct therapy through a video platform. Clinicians frequently address privacy and confidentiality, technology use, emergency procedures, client location, communication expectations, documentation practices, and jurisdictional considerations as part of the informed consent process.
Because telehealth services occur within a rapidly evolving legal, ethical, and technological environment, informed consent discussions may continue throughout treatment as circumstances change. Revisiting important topics, updating documentation, and maintaining open communication can help support transparency and promote informed decision-making.
A thoughtful telehealth informed consent process helps clients understand how services will be delivered, what expectations apply, and how important situations such as emergencies, technology disruptions, privacy concerns, and location changes will be handled. Developing a systematic approach to these conversations can help clinicians provide telehealth services with greater confidence and clarity.
Research Reference
U.S. Department of Health and Human Services. (2024, September 18). Obtaining informed consent for
telebehavioral health. Telehealth.HHS.gov. https://telehealth.hhs.gov/providers/best-practiceguides/
telehealth-for-behavioral-health/preparing-patients-for-telebehavioral-health/informedconsent-
Code of Federal Regulations. (2025). 42 C.F.R. § 410.78 – Telehealth services.
https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-410/subpart-B/section-410.78
U.S. Department of Health and Human Services. (n.d.). Privacy laws and policy guidance.
Telehealth.HHS.gov. https://telehealth.hhs.gov/providers/best-practice-guides/privacy-and-securitytelehealth/
U.S. Department of Health and Human Services. (2024, February 8). Confidentiality of Substance Use
Disorder (SUD) patient records under 42 CFR Part 2: Final rule fact sheet. HHS.gov.
Center of Excellence for Protected Health Information. (n.d.). FAQs about 42 CFR Part 2. CoE-PHI.
https://www.asam.org/docs/default-source/advocacy/coe-phi-faqs-about-42-cfr-part-2.pdf
