What’s this resource?
This resource provides a clear, comprehensive, affirming, ethical Informed Consent Form template, designed for use by psychologists (particularly those working with adult clients).
It includes sections on privacy and confidentiality, communication, record-keeping, fees, Medicare referrals, private health insurance, cancellation policies, rights and responsibilities, what clients can expect from you as a practitioner, and more.
It also contains a dedicated section written specifically to support the health/wellbeing of neurodivergent, chronically ill, and/or otherwise disabled psychologists, helping you communicate access needs, boundaries, capacity variability, and practice structures in a clear, dignifying, professionally appropriate way.
Who is this resource for?
AHPRA-registered psychologists (especially those working in private practice, and with adult clients)
Practitioners who manage fluctuating capacity (such as neurodivergent, chronically ill, and/or otherwise disabled practitioners)
Practitioners wanting a clearer, more comprehensive informed consent form / process
This resource may also be useful for other allied health practitioners or therapists, however it is important to note that all professions and/or roles have specific ethical, legal, and professional requirements that must be adhered to, which may not be captured in this resource.
What’s included?
This resource includes:
A full, editable copy of the Informed Consent Form template (Word Doc and PDF versions), which can be customised and adapted to suit your context
An example completed version of the template (PDF version)
Purchasing this resource grants permission for the purchaser to:
Use this resource for your own independent learning
Use this resource as a template within your own personal independent practice (e.g. as an informed consent form shared with your clients/patients as part of the informed consent process)
GST is included in the price.
Licensing
Please note, this resource is individual use / license only. It is not intended for sharing, redistribution, resale, or use across multiple practitioners, clinics, or organisations.
If you would like to purchase this resource for use in non-individual contexts (e.g. for use across multiple practitioners, clinics or organisations, and/or for inclusion in training, workshops, organisational resources, or resource libraries), please contact hello@lgpsychology.net to discuss licensing / purchase options.
How do I download it?
When you’re ready, click the cart icon to review, confirm, and process your purchase.
After purchasing, you’ll receive a secure link to a downloadable ZIP file containing the three files included in this resource.
Once you have downloaded and “unzipped” (i.e. opened) this file, you’ll have access to the Word Doc and PDF files, ready to use.
Disclaimers
This resource was created and made available for purchase on 29/11/2025, in line with the new PBA Code of Conduct (effective as of 01/12/2025), by Lumen Gorrie. Lumen Gorrie is not responsible for any changes in content validity that may arise due to any changes in ethical, legal, or professional requirements of psychologists that occur following that date.
This resource is intended for use as a general template, and is not a substitute for legal advice. Please note that regardless of your profession and/or role, it is your responsibility to use this resource in a way that is appropriate for and adheres to all ethical, legal, and professional requirements. Please adapt it to your own circumstances as appropriate, and seek legal advice if required.
Thank you!
I hope you find this resource useful :)
What’s this resource?
This resource provides a clear, comprehensive, affirming, ethical Informed Consent Form template, designed for use by psychologists (particularly those working with adult clients).
It includes sections on privacy and confidentiality, communication, record-keeping, fees, Medicare referrals, private health insurance, cancellation policies, rights and responsibilities, what clients can expect from you as a practitioner, and more.
It also contains a dedicated section written specifically to support the health/wellbeing of neurodivergent, chronically ill, and/or otherwise disabled psychologists, helping you communicate access needs, boundaries, capacity variability, and practice structures in a clear, dignifying, professionally appropriate way.
Who is this resource for?
AHPRA-registered psychologists (especially those working in private practice, and with adult clients)
Practitioners who manage fluctuating capacity (such as neurodivergent, chronically ill, and/or otherwise disabled practitioners)
Practitioners wanting a clearer, more comprehensive informed consent form / process
This resource may also be useful for other allied health practitioners or therapists, however it is important to note that all professions and/or roles have specific ethical, legal, and professional requirements that must be adhered to, which may not be captured in this resource.
What’s included?
This resource includes:
A full, editable copy of the Informed Consent Form template (Word Doc and PDF versions), which can be customised and adapted to suit your context
An example completed version of the template (PDF version)
Purchasing this resource grants permission for the purchaser to:
Use this resource for your own independent learning
Use this resource as a template within your own personal independent practice (e.g. as an informed consent form shared with your clients/patients as part of the informed consent process)
GST is included in the price.
Licensing
Please note, this resource is individual use / license only. It is not intended for sharing, redistribution, resale, or use across multiple practitioners, clinics, or organisations.
If you would like to purchase this resource for use in non-individual contexts (e.g. for use across multiple practitioners, clinics or organisations, and/or for inclusion in training, workshops, organisational resources, or resource libraries), please contact hello@lgpsychology.net to discuss licensing / purchase options.
How do I download it?
When you’re ready, click the cart icon to review, confirm, and process your purchase.
After purchasing, you’ll receive a secure link to a downloadable ZIP file containing the three files included in this resource.
Once you have downloaded and “unzipped” (i.e. opened) this file, you’ll have access to the Word Doc and PDF files, ready to use.
Disclaimers
This resource was created and made available for purchase on 29/11/2025, in line with the new PBA Code of Conduct (effective as of 01/12/2025), by Lumen Gorrie. Lumen Gorrie is not responsible for any changes in content validity that may arise due to any changes in ethical, legal, or professional requirements of psychologists that occur following that date.
This resource is intended for use as a general template, and is not a substitute for legal advice. Please note that regardless of your profession and/or role, it is your responsibility to use this resource in a way that is appropriate for and adheres to all ethical, legal, and professional requirements. Please adapt it to your own circumstances as appropriate, and seek legal advice if required.
Thank you!
I hope you find this resource useful :)
