Payment Consent Form

About this template

Ensure that your clients and customers are giving their written consent for charges your company makes with this Payment Consent Form from Jotform Sign. Outline desired payment methods, the date the payment will occur, required client contact information, and other pertinent information. Create, customize, and send your consent form to your clients to collect their e-signatures and authorization.

Making changes to this Payment Consent Form is quick and efficient with our completely online form building process. Drag and drop to upload your company’s branding or logos, add or remove signature fields, change fonts and colors, and more. You can even create an automated signing order to ensure your form gets seen by the right clients, in the right order.

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These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.