Q01
Message
All templatesHealthcare & 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.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
13 questions · ~7 min
Q02
ConsentRequired
Please review the following before continuing.
Q03
Opinion ScaleRequired
How clearly do you understand the limits of confidentiality in group therapy — including that other members may not always keep what's shared private?
Scale: 1 – 5
Min:Not at all clearMax:Completely clear
Q04
MatrixRequired
How much do you agree with each statement about what you've been told regarding group therapy?
4 rows × 5 columns
- 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
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q05
Multiple Choice
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
Opinion ScaleRequired
How comfortable are you, right now, with the idea of sharing your own experiences in front of the other group members?
Scale: 1 – 7
Min:Not comfortable at allMax:Extremely comfortable
Q07
AI Interview
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
Multiple Choice
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
Long Text
Is there anything about your history, current situation, or preferences you'd like your facilitator to know before the group starts?
Q10
Multiple Choice
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
Dropdown
What is your age range? (optional)
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65+
- Prefer not to say
Q12
Multiple Choice
How do you describe your gender? (optional)
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q13
Message
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.
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- 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 TemplateA 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.
What it does well
- 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
Where it falls short
- 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 ConsentA 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.
What it does well
- 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
Where it falls short
- 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 TemplateThis 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.
What it does well
- Polished, distraction-minimal question flow typical of Typeform
- Established template for therapy consent broadly
- Easy to customize wording for a given practice
Where it falls short
- 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 TemplateA 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.
What it does well
- 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
Where it falls short
- 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
Frequently asked questions
What questions are in the “Group Therapy Informed Consent & Readiness Check” template?
The template includes 13 ready-to-use questions, starting with: “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…”. The full set is previewed above, and every question is editable.
How long does this survey take to complete?
Respondents typically finish the 13 questions in about 7 minutes.
Can I customize this template?
Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.
Is this template free to use?
Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
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