# What should a mental health consent form include?

URL: https://tymirahealth.com/resources/faqs/what-should-a-mental-health-consent-form-include
For: Clinicians | Mental health practice | Last reviewed 23 July 2026

**Answer:** A mental health consent form should explain the service and the provider's role, how confidentiality works and its limits, how records are kept and shared, communication and teletherapy arrangements, fees, cancellations and payment responsibility, caregiver involvement, the emergency process, and how consent can be changed or withdrawn. It should support real understanding, not just a signature. Exact wording must follow local law, the patient's age, the service type and clinic policy.

### In more detail

- Limits of confidentiality: when information may be shared for safety, legal, caregiver, payment or care-coordination reasons.
- Online and in-person care: teletherapy usually needs extra detail on platform use, privacy, backup contact, patient location and what happens if the connection fails.
- Fees: missed appointments, cancellations, refunds and who pays should be clear before care begins.
- Data use: explain how health data is collected, used, shared and protected under Kenya's Data Protection Act 2019, and record consent status, version and date with an audit trail.

Consent for children and adolescents depends on local parent, guardian and minor-consent rules. See [Guardian Consent for Minors in Mental Health Care](https://tymirahealth.com/resources/blog/guardian-consent-for-minors-in-mental-health-care).

Read the full guide: [Digital Consent Management for Mental Health Clinics](https://tymirahealth.com/resources/blog/digital-consent-management-for-mental-health-clinics)

> **Important:** This is general guidance, not a legal template. Consent requirements depend on the patient's age, the service, teletherapy, privacy law and clinic policy, so have your form reviewed locally.

> **Important:** If there is immediate danger or a medical emergency, contact emergency services now. In Kenya, call 999, 112 or 911. Outside Kenya, use the emergency number for your location.

## Related questions

- [Are social workers now regulated in Kenya?](https://tymirahealth.com/resources/faqs/are-social-workers-now-regulated-in-kenya)
- [Can a teenager consent to counselling without a parent in Kenya?](https://tymirahealth.com/resources/faqs/can-a-teenager-consent-to-counselling-without-a-parent-in-kenya)
- [Can family members or carers be given information about an adult client?](https://tymirahealth.com/resources/faqs/can-family-members-or-carers-be-given-information-about-an-adult-client)

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**About Tymira Health:** Tymira Health is a healthcare technology company based in Nairobi, Kenya. It builds Tymira360, a practice management and EHR platform for mental health, physiotherapy and dental providers, clinics, hospitals, NGOs and insurers across Africa.

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