Client Consent Form Template for Indonesia

A comprehensive legal document used in Indonesia to obtain and document informed consent from clients before providing services, treatments, or collecting personal information. This document complies with Indonesian regulations, particularly Law No. 8 of 1999 on Consumer Protection and relevant sector-specific legislation. It details the nature of services, associated risks and benefits, client rights and responsibilities, privacy considerations, and data handling practices. The form includes mandatory elements required by Indonesian law while maintaining clarity and accessibility for clients, with provisions for various circumstances such as the need for interpreters or guardian consent.

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What is a Client Consent Form?

The Client Consent Form is a crucial legal document required in various professional contexts within Indonesia. It serves as a formal record of informed consent, protecting both service providers and clients by clearly documenting the agreement for specific services or treatments. This document is mandated by multiple Indonesian regulations, including Law No. 8 of 1999 on Consumer Protection and Law No. 11 of 2008 on Electronic Information and Transactions. The form must be used before initiating any service that requires explicit client consent, particularly in healthcare, professional services, or situations involving personal data collection. It includes detailed information about the service provider, scope of services, client rights, privacy policies, and risk disclosures, all structured to meet Indonesian legal requirements while ensuring clarity for all parties involved.

What sections should be included in a Client Consent Form?

1. Client Information: Details of the client including full name, date of birth, identification number, and contact information

2. Service Provider Information: Details of the organization/professional providing the service, including registration/license numbers if applicable

3. Purpose of Consent: Clear statement of what services or activities the client is consenting to

4. Scope of Consent: Detailed description of what is covered by the consent, including any limitations or boundaries

5. Risks and Benefits: Clear explanation of potential risks and expected benefits associated with the services

6. Rights and Responsibilities: Outline of the client's rights (including right to withdraw consent) and responsibilities

7. Privacy and Confidentiality: Information about how client data will be collected, used, stored, and protected

8. Duration of Consent: Period for which the consent remains valid and conditions for renewal if applicable

9. Declaration and Signatures: Formal declaration of understanding and agreement, with space for client and witness signatures

What sections are optional to include in a Client Consent Form?

1. Interpreter Declaration: Required when consent is obtained through an interpreter, including interpreter details and confirmation of accurate translation

2. Guardian/Representative Authorization: Required when consent is given by someone other than the client (e.g., for minors or individuals lacking capacity)

3. Financial Information: Required when the services involve fees or financial obligations

4. Emergency Contact: Optional section for emergency contact information, particularly relevant for medical or high-risk services

5. Photography/Recording Consent: Required when services may involve taking photos, videos, or recordings

6. Research Participation: Required when client data may be used for research purposes

What schedules should be included in a Client Consent Form?

1. Schedule A - Detailed Service Description: Comprehensive description of services being consented to

2. Schedule B - Fee Schedule: Detailed breakdown of any applicable fees or charges (if relevant)

3. Appendix 1 - Rights and Obligations: Detailed explanation of client rights and obligations under Indonesian law

4. Appendix 2 - Privacy Policy: Detailed privacy policy and data handling procedures

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents

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Informed Consent And Health Declaration Form

An Indonesian-law compliant combined informed consent and health declaration document for medical procedures and treatments, meeting national healthcare regulatory requirements.

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Download a Standard Client Consent Form

Review your own Client Consent Form

What is a Client Consent Form?

What sections should be included in a Client Consent Form?

What sections are optional to include in a Client Consent Form?

What schedules should be included in a Client Consent Form?

Authors

Alex Denne

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