Optional Session Recording — Parent, Caregiver and Participant Consent
Version 2026-10-launch-recording-v3 · Last updated October 9, 2026. The clinician completes the session/authority fields and retains this identified form in its protected record. Do not send completed forms or clinical attachments to Nova by ordinary email. Every recording/upload still requires the session consent gate. This form does not authorize treatment, research, publication or a waiver of rights.
English form
Clinical provider and secure contact: ____________________ Local protected patient reference: ____________________ Session date/time/place: ____________________ Person giving permission and role: ____________________ Verified authority/capacity: ____________________ Other participants and their separate permission references: ____________________
The clinician asks to record audio only to review the session and prepare accurate clinical notes. It is optional: you may refuse, pause or stop recording and continue the supported care workflow without it. Voices and sensitive session information may be captured. No unrelated research, advertising, public sharing, model training, persistent voice identification or child account is authorized.
SLP Nova is operated by Sebastian Gonzalez, public seller SLP Nova · 4125 Hastings Street, Burnaby, BC V5C 2J3, Canada, hello@slpnova.com. Clinical core/private audio/database hosting is Microsoft Azure East US 2, United States. Necessary service access is limited to lawful purposes; foreign laws can require authority access. An alias does not guarantee anonymity.
Choose each relevant permission separately; none is selected in advance:
• [ ] Audio recording/storage for this session, for the purpose explained above and in my verified role.
• [ ] Transcription and speaker separation with Azure AI Speech Fast. Voice characteristics help distinguish speakers for clinician review; labels can be wrong. Microsoft says this fast service does not retain submitted input/output after processing; Nova separately keeps audio/transcript copies.
• [ ] AI documentation assistance with minimized transcript/session context in Azure OpenAI for clinician-reviewed report drafts. Processing can occur in other Microsoft regions; default monitoring may retain flagged content for authorized human review under Microsoft terms. No general model-training permission is given. If refused, the clinician uses the appropriate non-AI route for this recording/context.
Nova raw audio expires after 30 days, or earlier lawful deletion. Transcripts and clinical records can remain separately under the provider's legal retention duties, which the clinician explains and records here: ____________________. If the recording belongs to a required final record, the clinician retains that independent copy and explains its period. PG backups have a 14-day rolling cycle; other justified protected provider/backup copies follow their separate cycles and are not routinely reused. Nova's Retention Policy explains those duties and exceptions.
You can withdraw optional permission for future recording/processing through the clinical contact above, ask the clinician to stop immediately, and request access/correction/lawful deletion. Withdrawal does not undo completed lawful processing or erase a record the law requires. The clinician explains any restriction and coordinates Nova-copy rights. Identified forms stay with the provider; sensitive requests to Nova use secure delivery.
Explanation language: ____________________. I had a chance to ask questions and understand the selected purposes, processors/countries, retention and choices. I have authority to give these permissions. The capable child's/client's legally required choice is respected; a caregiver signature does not override capacity rights.
Consenting person's name/signature/date/time: ____________________ Clinician's explanation/authority verification/signature/time: ____________________ Required client consent/assent record: ____________________ Other adult participants' separate signatures/references: ____________________ Pause, withdrawal or amendment and time: ____________________