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Europe (EU) and other regions

Consent collection templates without specified privacy regulations

Aviva Glassman avatar
Written by Aviva Glassman
Updated this week

These resources are not specific to any region, but are intended for providers outside of the other regions that we cover who are looking for a privacy notice.

If you want to use your own documents to collect consent for processing personal data, rather than emailing your clients through Upheal, we offer two options. Choose the one that best suits your practice:

  1. Add a simple statement to your existing documents.

    or

  2. Use and distribute our template as-is or modified to your practice's needs. The template is the same form that you can email to your clients through Upheal.

Statement for existing forms

If you already have your own informed consent documents, you can include Upheal in your forms by adding these statements to remain compliant while using Upheal.

Make sure to replace [Name of the practice] with your own practice.

[Name of the practice] uses external providers to enhance services, including the Upheal platform. Upheal empowers counselors to concentrate on their services by offering automated notes and analytics for client conversations. As a part of this process, Upheal handles health information for counselors, adhering to the General Data Protection Regulation (GDPR).

[Name of the practice] has signed an agreement to protect data that is shared with Upheal. Under this agreement, Upheal adheres to regulations, ensuring that health information is safeguarded through appropriate administrative, physical, and technical measures, ensuring its confidentiality, integrity, and security. You can learn more about Upheal and its privacy practices at www.upheal.io/privacy.

Template for new forms

If you want to create a new consent form, you can download and use our template.

Please note:

The template is intended to serve as a basis for client consent and might require customization according to your specific operation and obligations. You as a Provider are responsible for the accuracy and applicability of the document.

Last Update: June 21, 2024

๐Ÿ“„ PDF version

๐Ÿ“„ Text version

If you'd like to make changes to the form, make a copy or download the document.

How to make a copy in your Google Drive

  1. Click File > Make a copy.

  2. Rename the document, choose the folder to save it in, and click Copy.

How to download for editing on your computer

  1. Click File > Download.

  2. Choose which file type you want to download, such as Microsoft Word (.docx).

  3. The download starts automatically, and then you can edit the new file on your computer.

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