Consent to treatment form template
A consent to treatment form records that a client has been told what a treatment involves, its risks, alternatives and aftercare, and agrees to go ahead. This version covers the practitioner and client details, the proposed treatment, risks, health information, how personal information is used, optional photographs, a section for clients under 18, and signatures. It is completed for each new client or course of treatment, with the treatment, risks and consents different each time.
Made by DocuWeave. Use at your own discretion.
What changes each time
29 values. Everything else is your wording, kept exactly.
The practitioner and business
- Practitioner's name and qualifications
- Business name
- Business address
- Business phone
- Business email
- Registration or professional body
The client
- Client's full name
- Date of birth
- Client's address
- Client's phone
- GP name and practice
The treatment
- Treatment proposed
- Reason for the treatment
- Number of sessions
- Price per session or course
- Price list date
- What the treatment involves
Risks, health and data
- Risks and what to do
- Alternatives discussed
- Aftercare
- Health questionnaire or consultation date
- Data contact
- Retention period
- Storage provider
Clients under 18 and signatures
- Client's age at treatment
- Reasons for the practitioner's assessment
- Parent or guardian's name and relationship
- Chaperone's name
- Signature dates
The rules it usually needs
Written in plain English when the template is set up.
- One of several wordings
“The legal basis for health information is either health care provision for a registered health professional, or the client's explicit consent.”
For a practitioner who is not a registered health professional, an explicit consent tick box is included.
- One of several wordings
“For a client under 18 the form follows one of three routes: 16 or 17, under 16 and able to consent, or under 16 and not able to.”
For a 15-year-old assessed as understanding the treatment, the form records the reasons and asks a parent to sign as well.
- Only when…
“Include the under-18 section, the photograph consent and the registration line only if they apply.”
When no photographs are taken, the photograph consent is left out.
- Once for each item
“A row for each risk or side effect discussed.”
Two risks were discussed, so the table has two rows.
- One of several wordings
“The health information refers either to a health questionnaire on a date or to the consultation on a date.”
When there was a questionnaire, the form quotes its date.
Questions people ask
Does a practitioner need written consent?
The law does not always require it in writing, but a signed record is good practice and is what insurers and professional bodies expect, especially for treatments involving touch, injections or equipment.
Can a child consent to treatment?
It depends on age, the treatment and the child's understanding. A young person of 16 or 17 is presumed able to consent to treatment, and a younger child can if the practitioner judges they fully understand it. Some treatments are banned for under-18s altogether.
Is health information special category data?
Yes, under the UK GDPR. A registered health professional may rely on the health or social care condition; others generally rely on explicit consent. The form sets out which applies.
Can a client change their mind?
Yes. The form says the client can stop the treatment at any time and can withdraw consent later.
Can I use my own consent form?
Yes. Upload your own Word or PDF version and DocuWeave turns it into a template in your wording, with the same kind of rules and the same filling from paperwork.
Use this template
It opens in DocuWeave as a template you can check, change and publish. Nothing is used until you do.