The simplest way to think about it: treat the AI scribe like an in-person scribe. You'd let a patient know if another person were in the room helping you document — the same courtesy applies here.
This article explains why consent matters for an AI scribe, how the rules differ from state to state, and a simple approach that works everywhere.
Not legal advice. This is general educational information to help you set up a sensible consent workflow. Recording and AI-disclosure laws vary by state and change often. Confirm your approach with your own legal counsel or compliance team before relying on it.
People often assume HIPAA covers this. It mostly doesn't — at least not the part you're asking about.
So the consent question for an AI scribe is really a recording-consent question, not a HIPAA question. That's why the answer depends on the state you're practicing in.
U.S. recording laws fall into two buckets:
As of 2026, the states generally treated as all-party consent are: California, Connecticut, Delaware, Florida, Illinois, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, Oregon, Pennsylvania, Vermont, and Washington. Several other states have introduced all-party bills recently, so this list should be verified against current law for your state.
The practical takeaway: ask every patient regardless of state. Even in one-party states, getting and documenting consent is best practice — it builds trust and it's your best protection if a patient ever objects.
The all-party consent states are listed below — these are the ones where you should secure the patient's agreement (and that of anyone else in the room) before recording. Every other U.S. state and Washington, D.C. follow one-party consent, where patient consent isn't strictly required to record but informing and documenting it remains best practice.
| All-party consent state | What to know |
|---|---|
| California | Strictest environment, with extra rules under the CMIA and active litigation. See the California guide. |
| Connecticut | Treat clinical audio as consent-required (civil liability attaches to recording calls without all-party consent). |
| Delaware | Consent required. |
| Florida | Exam-room conversations are private; consent required. See the Florida guide. |
| Illinois | Consent required; verbal satisfies the recording law. A separate biometric law (BIPA) and how it applies to speaker separation is unsettled — some Illinois clinics prefer written consent. See the Illinois guide. |
| Maryland | Consent required. |
| Massachusetts | Consent required; the statute is strict about secret recording. |
| Michigan | Consent required. |
| Montana | Notification/consent required. |
| Nevada | Consent required in practice; verbal is fine. See the Nevada guide. |
| New Hampshire | Consent required. |
| Oregon | In-person rules differ from phone rules; get consent for clinical audio. |
| Pennsylvania | Consent required. |
| Vermont | No specific statute, but courts protect private conversations; get consent. |
| Washington | Consent required — and capture the consent itself on the recording. See the Washington guide. |
Last reviewed: June 2026. These categories are general and laws change frequently. A few states (e.g., Connecticut and Oregon) treat in-person and phone recordings differently — see the individual state guides for detail — and you should verify your own state and confirm your approach with counsel.
Yes, in essentially every state — including all-party consent states. The law in all-party states requires that everyone agree to the recording; it does not require that the agreement be in writing. A clear verbal "yes" at the start of the visit satisfies the requirement.
The important caveat is documentation. Verbal consent is harder to prove later than a signature, so the standard recommendation is:
That layered approach — a verbal ask, a posted sign, and a note in the record — is the most defensible setup and works in all 50 states.
You don't need anything elaborate, and you have a few interchangeable methods. Pick whatever fits how your team already works:
1. Verbal consent during the visit (most common). A one-sentence heads-up at the start of the encounter, then a short note in the chart. Example documentation:
"Discussed the use of audio recording for clinical note transcription with the patient, who gave verbal consent to proceed."
A single verbal "yes" can cover the current visit and future visits with the same provider — you don't have to re-ask at every appointment, though a quick reminder is courteous.
2. A laminated card for medical assistants or front-desk staff. Some patients prefer to read rather than be told. An MA can hand over a short printed explanation and ask for agreement. (See the patient script in the Provider & Staff Guide companion document, which works as read-aloud or laminated text.)
3. A written or electronic consent form before the visit. If your clinic prefers a signed form, staff can send it ahead of time or collect it at check-in. Chartnote provides a starting point you can adapt with your legal/admin team: Sample Consent Form for AI Scribe.
4. A posted notice in the clinic. A sign in the waiting room and exam rooms reinforces that AI-assisted documentation is in use. (See the printable clinic notice.)
The most defensible setup layers a few of these: a verbal ask at the start, a posted notice on the wall, and a one-line note in the record that you obtained consent. That combination works in all 50 states. For new patients, adding a consent line to intake paperwork introduces it before the first recorded visit.
When you explain it to patients, two reassurances land well: the tool only uses the conversation during the visit and not afterward, and the records stay confidential, shared only with the care team and anyone the patient authorizes.
A family member or caregiver is in the room. In all-party states, their voice is captured too, so include them in the ask: a simple "I use an AI assistant that helps me write my notes — is everyone okay with that?" covers the room.
An interpreter is present. Same principle — make sure the interpreter and patient both understand and agree before recording.
The patient declines. Honor it immediately. Don't start the scribe; document the visit the traditional way. A patient can also withdraw consent mid-visit — stop the recording, and follow your data-handling policy on the partial recording.
Telehealth across state lines. When the patient and provider are in different states, the more protective state's law generally governs, and the patient's location matters. When in doubt, follow the all-party standard and get consent.
Outside the U.S. Other countries have their own rules. If you practice in Canada, see Understanding Consent Laws for Recording Clinical Visits in Canada.
| Question | Answer |
|---|---|
| Do I need consent? | Yes — ask every patient, in every state. |
| Does it have to be written? | No. Verbal consent is sufficient everywhere. |
| What's the catch? | Document that you obtained it. |
| Is my state different? | Check the Quick state reference above; all-party states have their own guide. |
The following resources are attached to this article:
This article is general educational information and not legal advice. Recording-consent and AI-disclosure laws vary by state and change frequently; confirm your clinic's approach with qualified legal counsel.
Last reviewed: June 2026.