OPTIONAL SESSION AUDIO RECORDING
TPCPT may occasionally use audio recording and AI to assist with clinical documentation when appropriate.

Recordings will be used for clinical documentation only and will not be used for marketing or any other purposes.
 

☐ I consent to optional audio recording of my therapy sessions.
☐ I do not consent to optional audio recording.

I understand that declining optional recording will not affect my access to care.
 

Patient Signature: ____________________ Date: ____________________

 

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CLINICAL PHOTOGRAPHY / VIDEO

Photographs or video may occasionally be useful for clinical documentation of my evaluation, treatment, or progress.

☐ I consent to photographs/video for clinical documentation.
☐ I do not consent to photographs/video for clinical documentation.

I understand that photographs or video will not be used for marketing, advertising, social media, publication, or other non-treatment purposes without separate written authorization.

Patient Signature: ____________________ Date: ____________________