Do patients have to consent to an AI scribe?

Two different bodies of law get tangled here. HIPAA governs what happens to the recording, and under 45 CFR 164.506 use for treatment needs no separate authorization. Whether you may record at all is state wiretap law. In one-party consent states, which follow the federal model in 18 U.S.C. 2511(2)(d), a clinician participating in the conversation can generally provide the consent the statute requires. All-party consent states require everyone in the room to agree before recording starts. On top of that patchwork, the Texas Medical Liability Trust reported in 2025 that several states now specifically require explicit patient consent for AI-recorded health care encounters. Where your clinic lands in that patchwork is a one-time question for your counsel.

The operational answer is easier than the legal one: ask everyone, every visit. One plain sentence from the treating therapist (“I use an AI assistant that listens and drafts my note. Okay with you?”), a verbal yes, and a plan for the patient who declines: the therapist types that visit’s note the old way. Asking costs five seconds and builds trust instead of spending it.

With Aurora, the ask and the start are the same moment: the patient hears it from their therapist, agrees, and one tap begins the visit. No form at the kiosk, no separate recording app on the counter.