Patient Consent for AI-Assisted Clinical Documentation (Mental Health Services)
Purpose
Our mental health clinic uses secure AI-assisted dictation tools to help clinicians accurately and efficiently document your visit. This consent explains how this technology is used and how your information is protected.
How AI-Assisted Dictation Is Used
- During or after your appointment, your clinician may use AI-assisted dictation to help create clinical notes.
- The technology may process spoken information from your session to generate a draft note.
- All notes are reviewed, edited, and approved by your licensed provider.
- The AI tool does not provide therapy, diagnosis, or clinical decision-making.
Privacy and Confidentiality
- The AI system is designed to comply with HIPAA and applicable state and federal privacy laws.
- Audio is not permanently stored unless required for clinical, legal, or quality purposes.
- Your mental health information remains confidential and is protected using appropriate security safeguards.
Your Choice
- Your participation is voluntary.
- You may decline or withdraw consent at any time without affecting your access to care.
- If you decline, your provider will document your session using traditional methods.
Patient Consent
By signing below, you acknowledge that you understand and consent to the use of AI-assisted dictation for documentation during your mental health care.

