Template

Informed Consent — Digital Sandtray

Two versions: one for adult clients, one for parent/guardian of a minor. Covers the nature of sandtray, digital format and screenshot documentation, telehealth considerations, privacy and data handling, limits of confidentiality, and FERPA/HIPAA applicability. Fill your practice details in the header fields, then print.

Legal disclaimer

This template is a starting point for informed consent language, not legal advice. Consent requirements vary by state, license type, setting (school vs. clinical), and payer. Review this language with your supervisor, your professional liability carrier, and if applicable your school district’s legal counsel before using it with clients. The FERPA and HIPAA language here is general — your obligations depend on your specific role and setting.

Fill in your practice details below. These appear in the document header when printed.

Fill in your practice details below. These appear in the document header when printed.

How to use these templates

Fill in your practice or school name, clinician name, address, and contact number in the fields above the document. These populate the header automatically. Switch between the Adult and Parent/Guardian versions using the tabs above. When ready, click Print / Save as PDF — only the active version prints.

Most counselors keep a stack of pre-printed consents with just the practice header filled in, and complete the signature fields in person with the client or guardian. The body of the document should not be modified without legal review — if your setting requires different language, consult your district counsel or liability carrier.