Section 5 (Psychiatric Medications Consent Forms)


The Health Care Agency?s Adult Mental Health Services Program has developed 13 medication consent forms covering seven categories of psychiatric medications. The category format should allow adding new medications over the years without drafting additional forms.

These forms are based on California law and previous HCA consent forms explaining the purpose of the medication, the possible benefits of the medication, the possible side effects of the medication, and any possible adverse reactions from the medications. The forms also contain "patient instructions" for managing possible side effects or adverse reactions.

The consent form is documentation that a clinician has discussed the medication with each patient prior to prescribing. For patients who are willing to take medications, have heard the benefits and risks, but will not sign (i.e. because of guardedness, etc.), it is acceptable to put an unsigned consent form on the chart with notation that information was given and why the patient did not sign. Equally important, the clinician should sign the form.

A copy of the consent should remain in the patient?s chart and a copy should be given to the patient - so that the patient may use the form for educational purposes.

The side effects are listed in decreasing order of frequency, with sexual side effects included in much more detail. Uncommon or rare side effects which are potentially serious when they do occur, are highlighted.

The "General Medication Consent Form" has been relabeled "Non-Psychoactive Medication.") This general consent form is not required for non-psychotropic medications (such as ASA, Tylenol, cold medications, anti-hypertensives) used for medical conditions that are commonly treated in inpatient settings, and rarely, if ever treated by the outpatient clinics. But, if Benadryl (antihistamine) is used to treat EPS or insomnia, or Catapress or Inderal (antihypertensives) are used for to treat agitation or side effects, or Synthroid (thyroid hormone) is used as a antidepressant adjuvant then these should be included on the Non-Psychoactive Medication Consent. There is a separate consent for medications that treat EPS.

Adult Medication Consent FormsĀ 

Psychotropic Medication Consent Form: