Consent to record counseling sessions



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CONSENT TO RECORD COUNSELING SESSIONS

I, ________________________________________________, hereby give consent to my assigned

(client's name)

counselor, __________________________________________, at the Counseling Center at the State University of New York at Buffalo to:


videotape__________ (initial if Yes)

audiotape__________ (initial if Yes)


our counseling sessions. These recordings will be used to aid the counseling process and to gain further understanding of important aspects of the treatment. I have discussed this procedure with the counselor, including the Counseling Center's policy on confidentiality.
I understand that refusal to sign this form will not affect my eligibility for receiving services at this agency.

Signed ___________________________________ Date____/____/______

Counselor__________________________________ Date____/____/______

(7/98)

CONSENT TO OBSERVE COUNSELING SESSIONS

I, _________________________________________, hereby give consent for counselors at the

(client's name)

Counseling Center of the State University of New York at Buffalo to observe my intake/counseling

sessions. Observation of these sessions is strictly for the purposes of training and consultation among Counseling Center staff, and observers are subject to the same rules of confidentiality as applies to the primary counselor/client relationship.


I understand that refusal to sign this form will not affect my eligibility for receiving services at this agency in any way.

Signed ___________________________________ Date____/____/______



Intake Counselor___________________________ Date____/____/______

(7/98)





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