Veteran Support Therapy Session Observation Consent Form
Please complete this form to provide your consent for observation of the veteran support therapy session. Your participation is voluntary and your privacy will be respected.
Full Name of Participant
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Veteran Support Group
*
Please Select
Veteran
Family Member
Therapist/Facilitator
Observer
Other
Date of Session
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Session Location
*
Observer’s Full Name
*
First Name
Last Name
Purpose of Observation
Do you have any questions or concerns regarding the observation?
Submit Consent
Should be Empty: