Free Therapy Consent Form Template

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Free Therapy Consent Form Template

Therapy Consent Form

This consent form is designed to outline the purposes and obtain your consent for participation.

Name

Please provide your full legal name.

Address

Please provide your current address.

Email

Please provide your email address.

Do you understand the purpose of this activity?

    Do you agree with how the information will be used?

    Are the objectives of this research/project clear to you?

    Do you consent to participate?

    Please select an option to indicate your consent.

    • Yes

    • No

    Additional comments

    Any additional comments or questions.

    Owner

    [Your Name]

    [Date Signed]

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