Here is an example of Informed Consent for the clinicians that Stephanie Cook, LCSW teaches in her clinical courses. It is free for duplication, editing, and reuse.
Stephanie Cook, LCSW, is a licensed couples therapist and the owner of an Atlanta private counseling practice, Counseling ATL, LLC. She helps people improve their relationships, alone or together, in person or online. She has completed all levels and specializations of training in The Gottman Method of Couples Therapy. Her office is located in the Poncey-Highlands neighborhood of Atlanta, with convenient access to I75/I85 (exit Freedom Parkway), centrally located to all in-town neighborhoods such as Virginia Highland, Morningside, Midtown, Downtown, Emory University, and Decatur.
Jessica Settle, a graduate student completing her master's degree at Mercer University in counseling, currently works under the supervision of Stephanie Cook, has completed level 1 Gottman Method Couples Therapy, and has availability to see individuals, couples, and families on evenings and weekends.