Informed Consent for Medications F-24277 Series: Psychotropic Medications

In Wisconsin, people receiving health care have a right to participate in the planning of their treatment.

Informed consent is the process in which a health care provider educates a patient about the risks, benefits, and alternatives of a treatment. The patient must be competent to make a voluntary decision about the treatment.

Written informed consent is required for the use of psychotropic medications. If written informed consent is not given, the psychotropic medication cannot be administered without a court order unless in an emergency.

For the convenience of health care providers and to comply with requirements listed in Wis. Stat. § 50.08, informed consent forms for many psychotropic medications are provided below in both Adobe PDF (suitable for printing and completing by hand) and Microsoft Word (suitable for completing electronically and printing for signatures).

These forms are reviewed regularly and updated as needed.

Forms listed with a "Blank" medication name are the base form available in English and Spanish versions. Complete a blank form if no prefilled version exists for the prescribed psychotropic medication.

The Client Rights Office accepts questions about these forms and suggestions for improvements.

The list below can be narrowed down by the medication name (brand or generic), file type, and medication category.

Medication brand name Sort descending Medication generic name Last revised Medication category Language File type
Abilify, Abilify Maintena, Abilify MyCite, Aristada, Aristada Initio aripiprazole 08/2020 Antidepressant, Antipsychotic, Bipolar, Mood stabilizing English Word
Abilify, Abilify Maintena, Abilify MyCite, Aristada, Aristada Initio aripiprazole 08/2020 Antidepressant, Antipsychotic, Bipolar, Mood stabilizing English PDF
Adderall, Adderall XR dextroamphetamine and amphetamine 05/2021 Central nervous system stimulant English PDF
Adderall, Adderall XR dextroamphetamine and amphetamine 05/2021 Central nervous system stimulant English Word
Ambien, Ambien CR zolpidem 09/2019 Hypnotic, Sedative English Word
Ambien, Ambien CR zolpidem 09/2019 Hypnotic, Sedative English PDF
Anafranil clomipramine 10/2021 Antidepressant, tricyclic English Word
Anafranil clomipramine 10/2021 Antidepressant, tricyclic English PDF
Aricept donepezil 05/2020 Alzheimer's treatment, Dementia English Word
Aricept donepezil 05/2020 Alzheimer's treatment, Dementia English PDF
Aristada aripiprazole lauroxil 08/2018 Antipsychotic English Word
Aristada aripiprazole lauroxil 08/2018 Antipsychotic English PDF
Artane trihexyphenidyl 09/2019 Antidyskinetic English PDF
Artane trihexyphenidyl 09/2019 Antidyskinetic English Word
Atarax hydroxyzine hydrochloride 08/2022 Antianxiety, Antihistamine, Sedative English PDF
Atarax hydroxyzine hydrochloride 08/2022 Antianxiety, Antihistamine, Sedative English Word
Ativan lorazepam 10/2021 Antianxiety, Anticonvulsant, benzodiazepine English PDF
Ativan lorazepam 11/2017 Antianxiety, Anticonvulsant, benzodiazepine English Word
Aventyl Pamelor nortriptyline 09/2019 Antidepressant, tricyclic English PDF
Aventyl Pamelor nortriptyline 09/2019 Antidepressant, tricyclic English Word
Belsomra suvorexant 08/2018 Hypnotic, Sedative English PDF
Belsomra suvorexant 08/2018 Hypnotic, Sedative English Word
Benadryl diphenhydramine hydrochloride 05/2020 Antianxiety, Antihistamine, Sedative English PDF
Benadryl diphenhydramine hydrochloride 05/2020 Antianxiety, Antihistamine, Sedative English Word
Blank Blank 05/2024 Not applicable Spanish Word
Blank Blank 05/2024 Not applicable English Word
Blank Blank 05/2024 Not applicable English PDF
Blank Blank 05/2024 Not applicable Spanish PDF
BuSpar buspirone 10/2021 Antianxiety English PDF
Buspar buspirone 10/2021 Antianxiety English Word
Caplyta lumateperone 07/2020 Antipsychotic English PDF
Caplyta lumateperone 07/2020 Antipsychotic English Word
Catapres clonidine 05/2020 Alpha adrenergic agonist antihypertensive English PDF
Catapres clonidine 05/2020 Alpha adrenergic agonist antihypertensive English Word
Celexa citalopram 10/2021 Antidepressant, SSRI English PDF
Celexa citalopram 10/2021 Antidepressant, SSRI English Word
Clozaril clozapine 08/2018 Antipsychotic, Atypical English PDF
Clozaril clozapine 08/2018 Antipsychotic, Atypical English Word
Cogentin benztropine 10/2018 Anticholinergic English PDF
Cogentin benztropine 10/2018 Anticholinergic English Word
Compro prochlorperazine 09/2019 Antiemetic, Antipsychotic English PDF
Compro prochlorperazine 09/2019 Antiemetic, Antipsychotic English Word
Corgard nadolol 10/2018 Beta-adrenergic blocker English PDF
Corgard nadolol 10/2018 Beta-adrenergic blocker English Word
Cymbalta duloxetine 10/2019 Antidepressant English PDF
Cymbalta duloxetine 10/2019 Antidepressant English Word
Dalmane flurazepam 11/2017 benzodiazepine, Hypnotic, Sedative English Word
Dalmane flurazepam 11/2017 benzodiazepine, Hypnotic, Sedative English PDF
Daytrana methylphenidate transdermal 05/2021 Central nervous system stimulant English Word
Daytrana methylphenidate transdermal 05/2021 Central nervous system stimulant English PDF