Pediatric Anxiety Treatment Consent Form

Streamline Pediatric Mental Health Consent with Paperform

When treating childhood anxiety, clear communication and comprehensive consent are essential. Mental health providers, pediatric practices, and family therapists need a consent process that addresses therapy approaches, medication considerations, school coordination, and family participation—all while remaining HIPAA compliant and accessible to families under stress.

This Pediatric Anxiety Treatment Consent Form template gives mental health professionals a structured, compassionate way to gather informed consent for anxiety treatment in children and adolescents. Instead of juggling paper forms, email threads, and phone tag with parents, you can present families with a clear, professional intake experience that covers every aspect of the treatment journey.

Why mental health providers choose Paperform for consent forms

Mental health practices—from solo therapists to group practices and hospital-based pediatric teams—rely on Paperform because it combines clinical thoroughness with family-friendly design. You can customize this template to match your practice's tone, add your logo and branding, and embed it directly on your website or share it via a simple link. Parents can complete the form on any device, review treatment options at their own pace, and ask questions before signing.

Paperform's conditional logic means you only show relevant questions: if a family indicates interest in medication management, you can surface additional consent fields. If they're already working with a school counselor, you can capture coordination details. This keeps the form focused and respectful of each family's time.

What this pediatric anxiety consent template includes

This template is designed to gather everything you need for compliant, informed consent:

• Patient and parent/guardian information with emergency contacts
• Presenting concerns and anxiety symptoms including specific triggers and severity
• Treatment modality preferences such as Cognitive Behavioral Therapy (CBT), play therapy, exposure therapy, or family therapy
• Medication considerations with consent for psychiatric evaluation and medication management if appropriate
• School involvement and accommodations including 504 plans, IEPs, and permission to coordinate with school staff
• Family participation requirements and expectations for parent/caregiver involvement in treatment
• Insurance and billing authorization with clarity on out-of-pocket costs
• HIPAA authorization and confidentiality with specific guidance on minors' rights and parental access
• Crisis protocols and safety planning with 24/7 emergency contacts
• eSignature fields for parents, guardians, and (when appropriate) older adolescents

Every section can be tailored to your practice's protocols, treatment philosophy, and state regulations.

From consent to coordinated care with Stepper

Once a family submits this form, the real work begins—and that's where Stepper (stepper.io) becomes invaluable. Use Stepper to automatically route new consents to the right clinician, create a new patient record in your EHR or practice management system, send a welcome packet with intake paperwork, schedule the first appointment, and notify your billing team to verify insurance.

If a family indicates they'd like school coordination, Stepper can trigger a task for your care coordinator to request a release of information and reach out to the school counselor. If medication management is part of the plan, Stepper can alert your psychiatric nurse practitioner or referring psychiatrist. This kind of smart automation ensures nothing falls through the cracks during the critical intake phase.

Add Papersign for streamlined eSignatures

Many states and insurance plans require a "wet signature" or secure eSignature on treatment consent forms. With Papersign (papersign.com), you can turn this form submission into a formal consent document and send it to parents for legal eSignature—all within the same workflow. Papersign keeps an audit trail of who signed, when, and from what device, giving you HIPAA-compliant proof of consent that's ready for chart review or audit.

Parents can sign on their phone while sitting in your waiting room or at home after reviewing the details. No printing, scanning, or mailing required.

Built for pediatric mental health workflows

This template is ideal for:

• Child and adolescent therapists offering anxiety-focused treatment
• Pediatric psychiatry practices managing medication and therapy
• School-based mental health programs coordinating with families and educators
• Group practices and clinics standardizing intake across multiple providers
• Hospital outpatient behavioral health integrating with larger health systems

Whether you're a solo practitioner or part of a multidisciplinary team, Paperform gives you a professional, mobile-friendly consent process that respects the complexity of pediatric mental health care.

HIPAA compliance and data security

Paperform is SOC 2 Type II compliant with robust data encryption, role-based access controls, and data residency options. While Paperform is not a HIPAA-compliant solution, it provides enterprise-grade security features that many healthcare practices use for non-PHI workflows or as part of a broader compliance strategy. Always consult your compliance officer to ensure your consent and intake processes meet your organization's requirements.

Customize, brand, and launch in minutes

Start with this template, adjust the questions to match your treatment model, apply your practice's colors and fonts, and publish. You can embed the form on your website, link to it from your EHR patient portal, or send it directly to families via email. Paperform's doc-style editor means you can add a reassuring intro paragraph, include a photo of your clinic, or link to educational resources about childhood anxiety—making the consent process feel personal, not transactional.

Over 500,000 teams worldwide trust Paperform to handle their most important forms, from healthcare intake to client onboarding to payment processing. Join mental health providers who are using Paperform to create a smoother, more compassionate intake experience for the families they serve.