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Do I need to use a specific informed consent form?

  • Legal disclaimer: The information contained on this page is the result of input and edits from a number of individuals and represents the current consensus of the members of the ACORN community that have contributed to this page. The information contained on this page is not intended as legal advice. All practitioners are encouraged to seek their own legal counsel if they have concerns regarding the requirements for informed consent.
The Outcomes Informed Care Initiative does not require that you alter whatever informed consent forms you currently use in your practice. If you wish to alter your informed consent forms to include discussion of the routine use of outcome questionnaires, you are free to use your professional judgment to choose language that best fits the needs of your practice.

Please bear in mind that the questionnaires are designed to be used as part of routine clinical care and do not constitute experimentation on human subjects. The questionnaires are also designed so as not to contain personally identifying information that might compromise your clients' privacy.

Sample Informed Consent Language

The following is sample language that you may choose to incorporate into any Informed Consent for Treatment form that you employ in your practice. This sample language is provided as a starting point for discussion only, and is not intended to serve as legal advice.

A growing body of research suggests that routine and frequent use of outcome questionnaires is associated with better treatment outcomes. Information from the questionnaires help the clinician and client monitor improvement and make adjustments in the treatment plan as necessary. For this reason, you may be asked to complete a brief questionnaire as part of your treatment. Please respond as honestly as possible because this will help your doctor or therapist evaluate if the treatment is effective for you.

Your therapist subscribes to an outcomes measurement service (The Center for Clinical Informatics) that provides automated scoring and interpretation of the outcome questionnaires. The service will help you and your therapist monitor your improvement.

Please be assured that your personal information is kept strictly confidential. The questionnaires remain anonymous, identified only by an ID number that is assigned by your therapist. The only information which is disclosed is an ID number, the questionnaire, your age, gender, diagnosis, general health status, and whether you have received mental health treatment previously. The outcomes measurement service center and qualified academic researchers may use the data to investigate ways to improve treatment outcomes. These research professionals do not have access to any information that could be used to personally identify you as an individual receiving treatment, nor do they have any access to your confidential medical records.

You are free to decline to complete the questionnaires. Refusal to complete the questionnaires will not affect your treatment or insurance coverage in anyway.

Do not fax consent forms to the Center for Clinical Informatics!

  • These contain sensitive patient information and are for your records only.

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