Permission to Record

Permission to Record a Practice CI session for the Mentorship Program

I, ______________, hereby give permission to _________________, a participant in the Compassionate Inquiry Mentorship Program, to make audio and/or video recordings of our counseling session(s).

I understand that these recordings will be used solely for the purpose of mentorship and professional development within the Compassionate Inquiry Mentorship Program. They may be reviewed by the Mentee’s online Mentor and/or CI Certification Team members.

All individuals involved in providing or receiving mentorship are bound by the same ethical principles of confidentiality as professionals providing counseling. The contents of these recorded sessions are strictly confidential and will not be shared outside the following contexts:

• Individual Mentorship Sessions
• Group Mentorship Sessions

Recordings may be reviewed by CI Mentors and may be deleted once the mentoring session is complete.

I understand that:

• The recordings will not be used for any other purpose without my explicit written permission.
• I may request the deletion of my recordings once the Mentorship is complete.
• Any exceptions to the above conditions will require a separate permission form signed by me, the client, and the CI Mentee.

By entering my initials and name below, I acknowledge that this serves as my electronic signature. I confirm that I have read, understood, and consent to the terms outlined in this document.

Client’s Name (Printed): _______________________

Client’s Initials: _________

Date: _______________