You have moved your sessions outside the office. Maybe it is a wooded trail, a beach, or a barn. These settings can feel freeing and inspiring, and they often lead to powerful growth for your clients. At the same time, the open air brings a whole new set of rules that many clinicians overlook.
This shift is where informed consent becomes critical. Many healthcare practitioners rely on template forms pulled from their electronic medical record systems, often called EMRs. Those forms were never designed for the outdoors. When you take your practice outside, they can leave you exposed in ways that are easy to miss.
What Informed Consent Is Really About
The concept of informed consent is more than a legal hurdle or a signature on a page. It is an ongoing process of communication between you and your client. The goal is to ensure your client understands what the therapy involves and agrees to it knowingly.
A good informed consent document works like a roadmap. It explains where you are going, how you plan to get there, and what risks or complications may arise. When you move beyond traditional talk therapy, the risks, boundaries, and expectations change. Your consent needs to change with them.
Why EMR Forms Often Fall Short
Most EMRs offer a one-size-fits-all approach to paperwork. These forms are designed for the lowest common denominator of healthcare services. They usually only cover privacy rights, billing, and basic treatment concepts, which are important but incomplete. Your informed consent form needs to reflect the actual setting and activities involved, not just the standard language from your EMR.
A generic therapy consent form is unlikely to mention what happens if a client trips on a tree root during a walk-and-talk session. It probably does not address running into a neighbor at the beach during surf therapy. Using a standard form for unconventional therapy is like using a flat roadmap to navigate the mountains. Some parts may help, but they will not keep you from getting lost.
Walk-and-Talk Therapy and the Loss of Control
Walk-and-talk therapy highlights these issues quickly. Sessions often take place in public parks, neighborhoods, or trails. You cannot control the ground under your feet, the people around you, or the noise level. Weather can shift suddenly, and privacy is never guaranteed.
A therapy consent document written for an office setting does not prepare clients for these realities. Your informed consent form should explain that people may overhear conversations and that interruptions can happen. Clients deserve to know how you choose routes, how you handle safety concerns, and what limits exist in public spaces.
Surf Therapy and Physical Risk in the Real World
Surf therapy introduces even more variables. Open water brings changing tides, strong currents, and physical exertion. Clients may need a basic level of swimming ability and comfort in the ocean. Conditions can change quickly, sometimes requiring a session to end early or move to shore.
Informed consent should explain these risks in plain language. Therapy in the water is different from therapy in a room. This is not about discouraging clients. It is about helping them decide whether this approach fits their comfort level and abilities.
Equine Therapy and Working With Animals
Horses are large, powerful animals with their own instincts. Even calm, well-trained horses can react in unexpected ways. That unpredictability is part of what makes the work meaningful, but it also carries risk.
Your consent should explain the animal’s role, how sessions are structured, and the safety measures in place. It should also be honest about the limits of control when working with animals. Clients should understand that while precautions are taken, no outcome can be fully guaranteed when working with animals.
Privacy and Confidentiality Outside Four Walls
HIPAA confidentiality is the foundation of the therapeutic relationship. In an office, you control the environment. Doors close, voices are lowered, and privacy is protected. Once you step outside, that control changes.
In public settings, you cannot guarantee that no one will see or hear part of a session. Your informed consent should explain how privacy expectations change outdoors. Clients need to decide whether they are comfortable with the possibility of being observed or overheard.
Your document should also address what happens if you encounter someone either of you knows, including whether you will acknowledge them or wait for the client to lead. Planning for these moments in advance turns potential discomfort into a known part of the process.
Physical Safety and Fit for the Therapy
Unconventional therapies often involve physical activity that traditional talk therapy does not. Walking, surfing, or working around animals requires a basic level of physical ability. Clients should know what is expected of them physically and have an opportunity to raise any concerns before sessions begin.
This is not just about avoiding injury. It is about fit, not just injury prevention. Informed consent should invite clients to share concerns, health issues, or discomfort early. Clear communication supports both safety and effective treatment.
Boundaries in Non-Traditional Settings
When therapy feels casual, boundaries can blur. Walking side by side or sharing an activity can feel more like friendship than therapy. That shift can be confusing if you do not address it directly.
Your informed consent should clarify that even in relaxed settings, the professional relationship stays the same. You are still the therapist, and the purpose of the session remains clinical. Clear boundaries protect both you and your client and help keep the work focused.
Practical Details That Prevent Problems
Outdoor and activity-based therapy raises practical questions that office forms rarely cover. When does the session start and end if you meet at a trailhead or beach? What happens if it rains or the surf is unsafe? How are cancellations handled due to weather?
Addressing these details in writing prevents confusion later. It also reinforces that your practice is thoughtful and well-structured, even when it looks informal on the surface.
Informed Consent as a Living Document
Informed consent should not be written once and forgotten. As your practice grows and changes, your documents should evolve too. Adding a new modality or changing locations is a good reason to review and update your consent.
Client questions are often a signal that something needs clarification. When the same question comes up more than once, it belongs in writing. A strong consent document grows alongside your practice and supports it over time.
Get Help With Your Outdoor Therapy Consent Forms
If you provide walk-and-talk, surf, equine, or other outdoor therapy services, your informed consent documents should reflect the environment where care takes place. A generic office template is not enough. Jackson LLP can help you prepare consent documents that fit your practice. Schedule a free 15-minute consultation.
This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader. It should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.
