How to Tell Clients You Use AI for Notes (Without Losing Trust)

You bought an AI documentation tool to get your evenings back. Now you're staring at a harder question than any vendor demo prepared you for: what, exactly, do you tell your clients?

It feels like a small disclosure. It isn't. In late 2025, a proposed class action against a major California health system put the stakes in writing — and the way you answer this question depends almost entirely on one technical detail most clinicians never think to ask about: does your tool record the room, or does it just help you write?

This guide walks through what the law actually requires, what the major professional bodies now expect, why honest disclosure can quietly improve your consent rates, and how to write a disclosure you'd be comfortable defending. It's clinician and practice education — not legal advice. When in doubt about your state's recording statutes, talk to a lawyer licensed where you practice.

The line that changes everything: recording vs. drafting

There are two very different things a vendor can mean when they say "AI notes," and they carry very different legal weight.

The first is an ambient scribe. It listens to the live session through a microphone, transcribes the audio, and drafts a note from that transcript. SimplePractice describes its own Note Taker this way: a tool that "transcribes our sessions and then prepares a draft progress note," with audio deleted shortly after and transcripts retained for a limited window (SimplePractice, July 2025). Abridge, the tool at the center of the lawsuit below, similarly records the conversation and uses that audio to draft the note.

The second is a drafting assistant that never hears the room. The clinician types a short scratchpad of what happened, the AI turns that text — plus structured chart fields like diagnosis, goals, and interventions — into a polished draft, and the clinician edits and signs it. There's no microphone, no transcript, and no audio recording in the loop. This is how CoralEHR's AI documentation works: it drafts from clinician-typed notes and chart data, with no session recording required.

The architectural difference is the whole story for recording law, and the reason follows from the statutes themselves. Wiretapping and eavesdropping laws are triggered by recording a private conversation — capturing the audio — not by using software to write up notes afterward. The McDermott Will & Schulte AI Scribes FAQ frames its consent guidance specifically around tools that "record live doctor-patient conversations" (McDermott Will & Schulte, March 2026). If no audio is captured, the conduct those statutes regulate never happens.

An honest caveat: this distinction is sharpest under recording law, and it does not get you off the hook ethically. Professional bodies, as we'll see, expect disclosure of AI use whether or not a microphone is involved. And in practice, many compliance teams choose to treat all documentation tools uniformly rather than parse the line case by case. The point isn't that a non-recording tool needs no disclosure — it's that a recording tool needs more, and carries legal exposure a drafting assistant simply doesn't.

What the law actually requires for recording tools

If your tool records audio, all-party consent law is the part to take seriously.

Most U.S. states are "one-party consent" jurisdictions — one person in the conversation can lawfully record it. But roughly a dozen are all-party (also called two-party) consent states, where every participant in a private conversation must agree before it can be recorded, and recording without that consent can be a criminal offense. One commonly cited list names twelve — California, Connecticut, Delaware, Florida, Illinois, Maryland, Massachusetts, Montana, New Hampshire, Oregon, Pennsylvania, and Washington (Recording Law, 2026) — and a few more states (Michigan and Nevada among them) are borderline, written as all-party but read narrower by their courts. The exact count is genuinely contested across sources; the practical takeaway is that if you practice in a strict state, a recording scribe almost certainly requires consent.

The McDermott FAQ goes a step further than minimum compliance. As a best practice, it advises getting "any required consent from patients and caregivers each time an AI scribe tool is used" — not a one-time form buried in intake paperwork — and notes you should also get consent from family members or anyone else in the room during a recording (McDermott Will & Schulte, March 2026). For a telehealth session with a partner sitting just off-camera, that's a real operational wrinkle, not a hypothetical.

What happens when you skip this

In November 2025, a patient filed a proposed class action against Sharp HealthCare in San Diego County Superior Court over its use of Abridge's ambient documentation tool. The complaint alleges Sharp recorded confidential exam-room conversations without obtaining all-party consent, in violation of California's wiretapping law (CIPA) and its Confidentiality of Medical Information Act (CMIA) (Fisher Phillips, December 9, 2025).

The detail that should make every clinician sit up: according to the analysis, patient charts allegedly contained documentation stating patients "were advised" and "consented" to the recording — when, the suit claims, they were not and did not. The proposed class "may exceed 100,000 patients." These are allegations at an early stage, and Sharp had not yet responded when the analysis was published. But the lesson lands regardless of how the case resolves: a consent box that auto-fills in the chart is not the same as a consent conversation that actually happened, and a record that says otherwise is its own liability.

What the professional bodies expect — beyond the law

Recording statutes set a legal floor. Your licensing ethics set a higher one, and they apply even when no audio is captured.

The American Psychological Association issued ethical guidance on AI in the professional practice of health service psychology in June 2025 (updated December 2025). It is unambiguous that AI use should be disclosed: psychologists are encouraged to disclose AI use to "individuals who are receiving direct care services," and to "obtain informed consent by clearly communicating the purpose, application, and potential benefits and risks" of the tools they use (APA, June 2025). The guidance ties this to Principle E — respect for people's rights and dignity — and frames transparency as a way of letting clients make an informed decision about engaging with your practice at all.

Crucially, this obligation does not turn on whether the tool records. It turns on whether AI touches the client's care. A drafting assistant that never hears the session still uses AI to shape the clinical record, and the APA's logic — tell people what's being used in their care, and let them decide — reaches it. So the right mental model is two stacked obligations: recording law governs whether you may capture audio, and professional ethics governs whether you must disclose AI at all. A non-recording tool clears the first hurdle automatically but still has to clear the second.

Why honesty actually works in your favor

Here's the finding that reframes the whole conversation.

A JAMA Network Open study published July 22, 2025 looked at how much information you give patients changes whether they say yes to ambient AI documentation. When patients received only basic information about the technology, 81.6% consented. When they received fuller detail — about the AI's features, where the data is stored, and the corporate involvement behind it — consent dropped to 55.3% (JAMA Network Open, July 22, 2025).

It's tempting to read that as an argument for saying less. It is the opposite. Patients aren't reacting to the word "AI" — they're reacting to specifics: third-party data storage, corporate access, audio leaving the room. The more there is to disclose, the more disclosure costs you. Which means the cleanest path to a confident "yes" is having less to disclose in the first place.

That's the practical case for choosing a tool whose data story is genuinely simple. When the honest answer to "where does my session go?" is nowhere — no audio is recorded, the AI drafts from notes my therapist already typed, the conversation gets shorter and the trust gets deeper. Transparency stops being a risk to manage and starts being a feature you can lead with.

What CoralEHR's AI does — and what it deliberately doesn't

We hold our own documentation AI to the standard this article argues for, and it's worth being concrete about the boundaries — because the limits are the point.

• It drafts from your notes, not a recording. CoralEHR's AI generates a draft from the scratchpad you type plus structured chart fields. No microphone, no session audio, no transcript. There is nothing to wiretap.
• Drafts are preliminary until you sign. An AI draft persists in the record as a preliminary document (FHIR docStatus=preliminary) until a licensed clinician reviews and signs it. The AI never diagnoses, never decides, and never finalizes a note on its own.
• Treatment-plan AI is suggestions, not a plan. When the AI proposes treatment-plan content, those are options for a clinician to accept, edit, or reject — not a plan the software adopts. Guardrails forbid the AI from issuing diagnoses, treatment decisions, medication advice, or prognoses on every surface.
• A single, controlled AI path. Requests run over Anthropic's first-party Claude API on one enforced path. Inputs are not used to train models, operational logs carry hashed identifiers rather than session text, and treatment-plan drafts auto-delete after 30 days.

And the part that matters for client trust: CoralEHR signs a Business Associate Agreement before any protected health information is handled, governing PHI under 45 CFR Parts 160 and 164 (CoralEHR BAA). We're HIPAA-compliant and BAA-backed today. On the formal-attestation side, we're pursuing SOC 2 Type II and HITRUST — those are in progress, not held, and we'd rather tell you that plainly than imply otherwise.

The honest framing throughout is the same one we ask you to give your clients: the AI helps you write; a human stays accountable for what gets signed. For the longer argument on why that signature can never move to the software, see Why a Clinician Must Sign Every AI-Drafted Note.

How to write your disclosure

You don't need a lawyer to draft a good first version — you need to cover four honest things in plain language. (Do have counsel review it against your state's law before you rely on it.)

1. What the tool does. Name it. Say whether it records audio or works from notes you type. "I use an AI tool that helps me turn my own session notes into a draft. It does not record or listen to our conversation" reads very differently from "an AI transcribes our sessions" — because it is different.
2. Why you use it. Clients extend more grace when the reason is about them. The honest one usually is: less time on paperwork, more attention in the room.
3. How their information is handled. Is there a BAA in place? Is their data used to train anything? How long is anything retained? If the tool doesn't record, say so — it's the most reassuring sentence you have.
4. Who's accountable. State that you, a licensed clinician, review and sign every note, and that the AI never makes clinical decisions.

Then give a genuine choice, and document the answer through real consent — not a chart entry that fills itself in. SimplePractice offers a free sample form structured roughly this way (SimplePractice, July 2025), and the APA guidance (APA, June 2025) backs the disclose-and-choose structure. Adapt either to your tool and your state — and if your tool genuinely does less, your form gets shorter and your conversation gets easier.

For the broader compliance picture around private practice, our HIPAA guide for private-practice therapists covers the surrounding obligations; if you're weighing tools, our CoralEHR vs. SimplePractice comparison lays out the documentation differences side by side.

The bottom line

The question "how do I tell clients I use AI?" has a much easier answer when the tool is built to be easy to talk about. If it records the room, you're in all-party-consent territory, you owe a real consent conversation every time, and a class action in California is a reminder of what happens when the chart says "consented" but the client never did. If it only helps you write from notes you already took, there's no audio to consent to — but you still owe your clients honesty under professional ethics, and that honesty, done with specifics, is what earns the trust.

Either way, the move is the same: lead with the truth, keep a human accountable for every signed note, and pick a tool whose data story you'd be glad to read aloud to the person across from you.

Ready to see documentation AI that drafts from your notes instead of recording your sessions? Start a 30-day free trial — no credit card required — or book a demo to walk through it with us.

This article is clinician and practice education, not legal or clinical advice. Recording and consent laws vary by state and change over time; consult an attorney licensed in your jurisdiction and your own licensing board's current ethics guidance before relying on any disclosure or consent process.