About this template
This Sexual Consent Agreement template provides a structured way for consenting adults to communicate boundaries, preferences, and health status before an intimate encounter. By formalizing these discussions, all parties can ensure they are on the same page regarding expectations, comfort levels, and safety protocols. This template is designed to facilitate open, honest communication, which is the foundation of any healthy, consensual relationship.
Beyond basic identification, the form includes sections for health disclosures, a checklist of comfort levels for various activities, and the establishment of a 'safe word' to ensure that boundaries can be communicated clearly and respected at all times. Using Doc2Form, you can easily deploy this template as a Google Form to maintain a private, organized record of these agreements. It serves as a tool for mutual understanding and ensures that all participants feel empowered to define their own limits and expectations in a safe, respectful environment.
Key features
- Clearly define personal boundaries and comfort levels.
- Include fields for recent sexual health check-up dates.
- Establish a designated safe word for immediate communication.
- Define the specific timeframe for the agreement's validity.
- Fully customizable to suit individual preferences and needs.
Use cases
- Establishing clear boundaries for new intimate partners.
- Documenting mutual understanding of preferences and limitations.
- Facilitating proactive communication about sexual health and safety.
What this form collects
- Participant 1: Full Name (Short answer)Please enter your full legal name.
- Participant 1: Date of Last Sexual Health Check-up (Date)Providing this date helps us both stay informed about our sexual health.
- Participant 2: Full Name (Short answer)Please enter your full legal name.
- Participant 2: Date of Last Sexual Health Check-up (Date)Providing this date helps us both stay informed about our sexual health.
- Establish a Safe Word (Short answer)Choose a word that will be used to immediately pause or stop any activity if someone feels uncomfortable.
- Agreement Period (Short answer)When does this specific agreement begin and end?
- Consent Acknowledgement (Multiple choice)By checking this box, I confirm that I am participating voluntarily, I am of legal age, and I understand that I can revoke my consent at any time.
- Additional Notes or Boundaries (Paragraph)Are there any other specific preferences, boundaries, or things you would like to discuss?
FAQ
What is the purpose of this form?
The purpose is to facilitate clear, written communication between consenting adults regarding their boundaries, health status, and preferences before engaging in intimate activities.
Can consent be revoked after signing?
Yes. It is essential to remember that consent is ongoing. Any party can revoke their consent at any time during an encounter, regardless of what was previously agreed upon in writing.
How should I handle the sensitive data collected?
Because this form collects personal and health-related information, ensure you manage your Google Form responses securely. Use Google's built-in sharing settings to restrict access to only the necessary parties.
Is this form legally binding?
This template is intended as a tool for communication and mutual understanding between individuals. It is not a substitute for legal advice or a formal legal contract.
Get this form in your Google Drive
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