Client Signatures

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In telebehavioral health, telemental health and distance counseling, how do you obtain client signatures on relevant documents?  Do you wait to have your first session until you’ve received all of it?

Client signature requirements varies across practitioners, circumstances and states. Many states require informed consent with client signatures prior to treatment. Some states and guidelines suggest in-person assessments prior to remote care.

In-person assessments are still mandated in many U.S. states for telemedicine, where prescriptions are written. Many of these states do not have provisions for counseling, but if you get in trouble, related legal precedents such as medical law can easily be called into play. In general, do the same as you would do in-person for most of these dilemmas and you will be the safest.

If you are not seeing your client/patient in-person at any point, you have options.  Some platforms are offering client signature document services as part of their suite of features. You can simply click a link to upload your document to their portal. Your client/patient gets an email which asks them to come to the protected, HIPAA-secured portal to view and sign the document. When that is complete, you get an email telling to you the document is signed. Another option is to purchase a separate document signing services. Just be sure that the one you select offers HIPAA-compliant services and gives you a Business Associate Agreement (BAA) that protects you from their failures. If you prefer to not use a digitized system, but rather, just want to stick with printed forms, you can upload them to your website or other document storage service, ask them to download the forms, print, sign and send them back to you by snail mail or secured email. (Asking them to sign, scan and send these documents by unsecured email could be considered a security violation by HIPAA unless you have a prior informed consent regarding unsecured email. Our suggestion then is to be cautious with unsecured email.) Document exchange services are also available online, but many are not HIPAA-compliant. You can search Google to find one that is HIPAA compliant and affordable for your purposes.

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