Consent for use of HIPAA-compliant AI Software

Through the use of the BluePrint Health platform, you are agreeing to allow Brianna Doran of Soul Haven

Counseling, LLC to temporarily record your telehealth sessions for the purpose of composing an AI generated

note that will be revised and added to your case record.

The recording is not saved to ANY device and following the generation of the written note, the recording is

promply automatically deleted.

The AI generated note is then reviewed by Brianna Doran of Soul Haven Counseling & Consulting, LLC to

accuracy and authenticity and then submitted and signed off on in your client case record.

You do not have to agree to this service. However, if you have any questions or concerns, I encourage you to

reach out to me directly.

By signing below you are agreeing to the use of HIPAA-complaint AI software in the use of your care.