Consents and signatures

The Consents tab on a patient's chart lists every form the patient or someone around them signed: assignment of benefits, release of information, the notice of privacy practices acknowledgment, consent to treatment, telehealth consent, the financial policy and text message consent. Active consents come first.

Signature on file for claims#

The top of the tab shows two indicators that claims rely on:

• Box 12 release of information: on file while an active release of information exists.
• Box 13 assignment of benefits: on file while an active assignment of benefits exists.

A consent that has expired or was revoked no longer counts. When either one shows Missing, record the signed form. If the consents cannot be loaded, the badges say so instead; click Retry.

A release of information is also what lets you send records to an outside office; link it to the request as described in Records requests.

Record a consent#

1. Open the patient's chart and click the Consents tab.
2. Click Record Consent.
3. Choose the Consent, who it was Signed by (the patient or one of their contacts) and the Signed date. For a minor, the legal guardian is picked for you when the dialog opens, unless you have already started filling it in. If the contacts do not load, the dialog says the signer and phone choices are incomplete and offers Retry.
4. Enter Expires on if the form expires, for example a telehealth consent renewed every year.
5. Choose the Proof of signature:
   • Paper form on file: the clinic keeps the signed paper.
   • Scanned form: upload a PDF, PNG or JPEG of the signed form, up to 10 MB.
   • Sign now: enter the Consent wording the signer reads, then hand the device to the signer. Type (the default) shows the name of the person in Signed by in a signature style; Draw lets them sign with a finger, pen or mouse. The signer then checks the statement that they adopt the signature as their own. The wording is saved exactly as shown, so the signed consent never changes when your forms do. Changing Signed by afterwards clears the signature and the check, so the person named signs for themselves.
6. If the form is one of your clinic's handouts, turn on Signed on a clinic handout and choose it. The consent keeps the handout version that was signed and a copy of that file.
7. Click Record Consent.

To see a signed consent, open the row menu and click View Signed Consent. The whole record opens as a PDF: the consent wording as it was signed, who signed and their relationship to the patient, the date and time, how it was signed (in the clinic, through an intake packet link, or on paper), the signature with the device it was made on, and any scanned form or the copy of the intake form the signer read. Click Download to save it or Print to print it. Consents signed in the app before the wording was kept say so in place of the wording.

Acknowledge a new version#

A consent signed on a handout, in the clinic or through an intake packet, names the handout and its version. When the clinic publishes a new version of that handout and asks for it to be acknowledged again, the consent shows a Version 2 to acknowledge badge (with the new version's number).

To ask the family, open the row menu and click Ask to Acknowledge. The intake packet dialog opens with the same signer and a consent item on the new wording; create the link and send it. Once they sign, the new consent is listed and the badge goes away. You can also record the new signature in the clinic with Record Consent, choosing the same handout. The earlier consent stays on file as signed.

To ask many families at once, use the handout's waiting list in Setup > Handouts.

Text message consent#

When you record a Text message consent, pick the Phones covered. Only phones marked as able to receive texts are listed, both the patient's and their contacts'. Each phone you pick is marked as consenting to text messages from a signed form, the same consent you see next to the number on the Demographics and Contacts tabs.

AI use#

The AI use card at the top of the tab shows whether AI may help with this patient's records: note and report drafts, AI summaries, briefs, the assistant and ambient session notes.

• AI allowed means your clinic's AI notice covers the patient (clinic-level consent), or, when your clinic asks for consent first, that an AI documentation consent covering drafting is on file.
• Needs AI consent means your clinic asks for an AI documentation consent first and none is on file.
• No AI for this patient means the patient asked that no AI be used with their records. It shows the date, who recorded it and the reason.

When a patient asks that no AI be used, click Turn Off AI, add a reason if you like, and click Turn Off AI. AI drafts, summaries, briefs, the assistant and ambient session recording stop for this patient, the chart header shows No AI, and each AI action says why it is off. Dictation and read aloud stay available: they only turn the clinician's own voice into text, or text into speech, on their computer. Click Allow AI Again when the patient changes their mind; the earlier choice stays in the chart's history. Text AI already wrote into a note stays as it is.

AI documentation consent#

Record an AI documentation consent when the patient signs one, and pick what it Covers:

• Drafting from structured notes: a clinician may ask the assistant to draft note text from what they recorded about the visit, such as answers, codes, goals and activities.
• Audio and file capture: the assistant may also listen to a session or read uploaded files to draft from them.

Listening to a session or reading uploaded files always needs a consent in effect that covers Audio and file capture, whatever your clinic chose. Drafting from structured notes needs one only when your clinic's AI consent in Documentation Rules is Patient consent required; the AI action then says the consent is missing. Revoking the consent stops new AI use from that day on; text already in a note stays.

The patient can also decline AI for a single visit; see visits.

The stock privacy notice acknowledgment form (in the template catalog) explains the AI tools to patients: they help draft notes and summarize records, run through a HIPAA-covered AI service provider under a business associate agreement, never record a session without separate written consent, and the patient can ask for no AI at any time.

Revoke a consent#

When the signer withdraws a consent, open the row menu, click Revoke, pick the date, enter a reason, and click Revoke. The signed record stays on file with its revocation, and from that date it no longer counts. Revoking a text message consent also opts each phone it covers out of text messages.

Delete a consent#

Use Delete only for a consent recorded by mistake, such as one entered on the wrong chart. The record leaves the list but stays in the chart's history. Deleting does not change the text consent already recorded on a phone; revoke instead when the signer withdraws.