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
Tenormin atenolol 09/2024 Adrenergic, Beta, Blocker English PDF
Tenormin atenolol 09/2024 Adrenergic, Beta, Blocker English Word
Thorazine chlorpromazine 03/2018 Antipsychotic, phenothiazine English Word
Thorazine chlorpromazine 03/2018 Antipsychotic, phenothiazine English PDF
Tofranil imipramine 05/2020 Antidepressant, tricyclic English Word
Tofranil imipramine 05/2020 Antidepressant, tricyclic English PDF
Topamax topiramate 05/2021 Anticonvulsant, Migraine headache prevention English PDF
Topamax topiramate 05/2021 Anticonvulsant, Migraine headache prevention English Word
Tranxene clorazepate 09/2024 Antianxiety, benzodiazepine English PDF
Tranxene clorazepate 09/2024 Antianxiety, benzodiazepine English Word
Trilafon perphenazine 08/2020 Antipsychotic, phenothiazine English PDF
Trilafon perphenazine 08/2020 Antipsychotic, phenothiazine English Word
Trileptal oxcarbazepine 09/2024 Anticonvulsant English PDF
Trileptal oxcarbazepine 09/2024 Anticonvulsant English Word
Trintellix vortioxetine 05/2024 Antidepressant English PDF
Trintellix vortioxetine 05/2024 Antidepressant English Word
Valium diazepam 11/2017 Antianxiety, Anticonvulsant, Antispastic, benzodiazepine English Word
Valium diazepam 11/2017 Antianxiety, Anticonvulsant, Antispastic, benzodiazepine English PDF
Viibryd vilazodone 09/2024 Antidepressant English Word
Viibryd vilazodone 09/2024 Antidepressant English PDF
Visken pindolol 09/2024 Adrenergic, Beta, Blocker English Word
Visken pindolol 09/2024 Adrenergic, Beta, Blocker English PDF
Vivitrol, Revia naltrexone 05/2021 Blocker, Opioid English Word
Vivitrol, Revia naltrexone 05/2021 Blocker, Opioid English PDF
VRAYLAR cariprazine 06/2020 Anticonvulsant, Mood stabilizing English Word
VRAYLAR cariprazine 06/2020 Anticonvulsant, Mood stabilizing English PDF
Vyvanse lisdexamfetamine 05/2021 Central nervous system, Stimulant English PDF
Vyvanse lisdexamfetamine 05/2021 Central nervous system, Stimulant English Word
Wellbutrin, Zyban bupropion hydrochloride 09/2024 Antidepressant English Word
Wellbutrin, Zyban bupropion hydrochloride 09/2024 Antidepressant English PDF
Xanax alprazolam 09/2024 Antianxiety, benzodiazepine English Word
Xanax alprazolam 09/2024 Antianxiety, benzodiazepine English PDF
Xenazine tetrabenazine 09/2024 Agent, benzoquinolizine, Central nervous system English PDF
Xenazine tetrabenazine 09/2024 Agent, benzoquinolizine, Central nervous system English Word
Zoloft sertraline hydrochloride 09/2024 Antidepressant, SSRI English Word
Zoloft sertraline hydrochloride 09/2024 Antidepressant, SSRI English PDF
Zyprexa; Zyprexa Zydis;Zyprexa for Injection, Zyprexa Relprevv olanzapine 04/2021 Antipsychotic, Bipolar English PDF
Zyprexa; Zyprexa Zydis;Zyprexa for Injection, Zyprexa Relprevv olanzapine 04/2021 Antipsychotic, Bipolar English Word

Glossary

 
Last revised August 15, 2024