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Healthcare & Clinical

Group Therapy Informed Consent & Readiness Check

Confirms that a new group therapy member understands confidentiality limits, voluntary participation, and what to expect, while gauging comfort with sharing in front of others. An AI follow-up interview surfaces the specific worries behind low comfort or confusion so facilitators can address them before the first session. Built for therapists and group practices running intake.

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設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全13問・約7分
Q01
メッセージ

Welcome! Before your first group therapy session, we'd like to confirm you understand what to expect and check in on how you're feeling about it. Your responses are completely confidential and anonymized. This takes about 5 minutes and helps your facilitator prepare for you specifically.

Q02
同意必須

Please review the following before continuing.

Q03
オピニオンスケール必須

How clearly do you understand the limits of confidentiality in group therapy — including that other members may not always keep what's shared private?

スケール: 1 – 5
最小:Not at all clear最大:Completely clear
Q04
マトリクス必須

How much do you agree with each statement about what you've been told regarding group therapy?

4行 × 5列
  • I understand I can leave the group at any time
  • I understand what the facilitator will and won't keep confidential
  • I understand the potential risks and benefits of participating
  • I understand the expected time commitment and format
列: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q05
選択式

Which aspects of joining a group are you most concerned about, if any? Select all that apply.

  • Sharing personal information in front of others
  • Other members breaking confidentiality
  • Feeling judged or misunderstood
  • Not fitting in with the group
  • The time commitment
  • The cost
Q06
オピニオンスケール必須

How comfortable are you, right now, with the idea of sharing your own experiences in front of the other group members?

スケール: 1 – 7
最小:Not comfortable at all最大:Extremely comfortable
Q07
AIインタビュー

Explore the respondent's biggest hesitation about joining this group in concrete terms — anchor on whichever concern they flagged (confidentiality, judgment, fit, or something else) and ask what specifically they picture going wrong. If they said they're comfortable and have no concerns, probe gently for anything they'd still want the facilitator to know before the first session, such as topics they'd rather not discuss yet.

Q08
選択式

What would help you feel most prepared for your first session?

  • A short call with the facilitator beforehand
  • Written ground rules for the group
  • Knowing more about who else is in the group
  • A chance to ask questions before the session starts
  • Nothing — I feel ready
Q09
自由回答（長文）

Is there anything about your history, current situation, or preferences you'd like your facilitator to know before the group starts?

Q10
選択式

Have you participated in individual or group therapy before?

  • This is my first time in any therapy
  • I've had individual therapy but not group
  • I've had group therapy before
  • I've had both
  • Prefer not to say
Q11
プルダウン

What is your age range? (optional)

  • Under 18
  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65+
  • Prefer not to say
Q12
選択式

How do you describe your gender? (optional)

  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q13
メッセージ

Thank you for taking the time to complete this. Your facilitator will review your answers before your first session to help make the group a good fit for you — your individual responses stay within your clinical record and are not shared with other group members.

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Combines confidentiality and voluntary-participation consent language with comprehension checks (opinion scale, matrix) rather than just a signature capture
  • Uses an AI follow-up interview to explore the respondent's biggest hesitation about joining the group in concrete terms, giving facilitators specifics instead of just a low comfort score
  • Includes a long-text section for history, current situation, or preferences the respondent wants the facilitator to know before the first session
  • Gathers optional demographic context (age range, gender) and prior therapy experience alongside consent, so facilitators get readiness signals in one flow

Jotform

Group Therapy Informed Consent Form Template

A fielding-ready, customizable consent form focused on capturing agreement and disclosures for group therapy intake. It covers the standard legal/consent fields well but is built around static form fields rather than probing comprehension or comfort levels. Good for paperwork, not for surfacing hesitations before session one.

優れている点

  • Purpose-built for group therapy consent specifically
  • Likely offers e-signature and drag-and-drop customization typical of Jotform templates
  • Simple to deploy for intake paperwork

物足りない点

  • No adaptive follow-up to explore why a respondent is uncomfortable or confused
  • No built-in comprehension check or comfort scale distinct from consent itself
  • No automated quality scoring or auto-generated readiness report for facilitators

SurveySparrow

Group Therapy Consent Form | Informed Consent

A conversational-style consent form template aimed at collecting informed consent for group therapy. It benefits from SurveySparrow's chat-like UI, which can feel less clinical than a static PDF, but it's still a one-way form rather than an interview. There's no indication it dynamically follows up on low comfort or confusion.

優れている点

  • Conversational UI may feel friendlier for sensitive intake topics
  • Template is specifically scoped to group therapy consent
  • Likely supports basic branching/logic typical of SurveySparrow forms

物足りない点

  • No adaptive AI interview to dig into specific worries behind a low comfort rating
  • No voice AI or guided task option for richer intake
  • No transparent, published follow-up prompt methodology

Typeform

Psychotherapy Informed Consent Form Template

This template targets individual psychotherapy consent rather than group settings specifically, so some group-specific elements (confidentiality among peers, comfort sharing in front of others) may need manual adaptation. It has Typeform's clean, one-question-at-a-time UX, which is pleasant for consent flows, but remains a static questionnaire.

優れている点

  • Polished, distraction-minimal question flow typical of Typeform
  • Established template for therapy consent broadly
  • Easy to customize wording for a given practice

物足りない点

  • Built for individual, not group, therapy — lacks group-specific comfort/confidentiality framing out of the box
  • No adaptive follow-up interview to surface underlying hesitations
  • No automated per-response quality scoring or facilitator-ready report

SurveyMonkey

Therapy Consent Form Template

A general therapy consent template that can likely be adapted for group settings but isn't group-specific by default. It offers SurveyMonkey's familiar survey-building and reporting tools, useful for aggregate data across many intakes, but it doesn't interview individual respondents about their concerns.

優れている点

  • Backed by SurveyMonkey's mature survey infrastructure and analytics
  • Flexible enough to adapt for various therapy consent contexts
  • Straightforward to distribute at scale for practices with many clients

物足りない点

  • Not group-therapy-specific, so comfort-sharing-in-front-of-others framing is absent by default
  • No adaptive AI or voice interview to explore individual hesitations before session one
  • No transparent AI prompt methodology or automated readiness scoring

よくあるご質問

「Group Therapy Informed Consent & Readiness Check」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が13問含まれており、最初の設問は次のとおりです：「Welcome! Before your first group therapy session, we'd like to confirm you understand what to expect and check in on how…」・「Please review the following before continuing.」・「How clearly do you understand the limits of confidentiality in group therapy — including that other members may not alwa…」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、13問を約7分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

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