# AI Clinical Notes in Ontario and Quebec: What Therapists Need to Check

> A practical guide for Canadian therapists using AI clinical notes, covering consent, privacy, Ontario IPC guidance, CRPO expectations, and Quebec requirements.

*By Ignia · 2026-06-17*

Source: https://www.getignia.com/blog/ai-clinical-notes-ontario-quebec/

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AI tools that listen to a session and draft your clinical note are no longer a novelty. Many
Canadian therapists already use them, and many more are wondering whether they're allowed to.
The short answer: yes, but you're responsible for how they're used — and in 2026 that
responsibility got a lot more specific.

In the last few months, [Ontario's privacy regulator published formal guidance on AI
scribes](https://www.ipc.on.ca/en/resources/ai-scribes-key-considerations-health-sector),
Ontario's psychotherapy college [spelled out what it expects from registrants using
AI](https://crpo.ca/resources/ai-therapy/), and Quebec rolled out [its own approved-vendor
program](https://www.quebec.ca/sante/professionnels/programme-transcription-intelligence-artificielle)
under a privacy law with real financial teeth. If you're an RP, psychologist, or social worker
figuring out what you actually have to do before letting an AI draft your notes, this is the
practical version.

We build [Ignia](https://www.getignia.com/), a practice management platform with AI notes, so
we've had to learn these rules closely. This piece is useful whether or not you ever use our
product — every regulatory claim below links to its primary source.

**TL;DR:** AI notes are not automatically prohibited, but the therapist or clinic remains
responsible for consent, privacy, vendor due diligence, draft review, and province-specific
requirements. In Ontario, IPC and CRPO guidance point toward explicit consent, data
minimization, vendor review, and clinician accountability. In Quebec, confirm TGV certification,
EFVP/privacy assessment requirements, and applicable professional-order guidance before using a
tool.

## What "AI clinical notes" actually means

AI scribe, ambient documentation, AI transcription — the labels differ, the mechanics don't.
The tool captures the session (from a recording or in real time), transcribes the audio, and
drafts a structured note in your format, usually SOAP, DAP, or BIRP.

Be clear-eyed about one thing: the AI produces a *draft*. It decides nothing clinical and
should never be treated as if it does. Ontario's IPC, in its
[January 2026 news release](https://www.ipc.on.ca/en/media-centre/news-releases/ipc-releases-new-guidance-ai-scribes-help-protect-patient-privacy),
frames these tools as a way to reduce administrative burden, not as a clinical decision-maker.
That distinction is the foundation everything else sits on.

## What the rules now require in Ontario

Two Ontario bodies matter here, and they are looking at different things.

**The Information and Privacy Commissioner (IPC)** published *AI Scribes: Key Considerations
for the Health Sector* on [January 28,
2026](https://www.ipc.on.ca/en/media-centre/news-releases/ipc-releases-new-guidance-ai-scribes-help-protect-patient-privacy),
alongside a [companion
checklist](https://www.ipc.on.ca/en/resources/ai-scribes-checklist-key-considerations-health-sector).
It is aimed at organizations that hold personal health information, and it reads as a
practical guide for adopting these tools responsibly. A few points that affect a working
clinician directly:

- **Consent is explicit, and refusal cannot cost the client anything.** A client who declines
  the AI scribe has to receive the same standard of care as one who agrees. Consent buried in a
  long intake form is not the standard regulators are moving toward; they want the client to
  actually understand that AI is involved and what happens to their information.
- **Data minimization.** Collect only what is reasonably necessary, and question whether full
  session audio needs to be retained at all once the note is written.
- **Vendor due diligence.** If you are using a third-party tool rather than building your own,
  you are expected to vet the vendor and have an agreement that holds them to obligations around
  intended use, lawful training data, accuracy, monitoring, and security.

**The College of Registered Psychotherapists of Ontario (CRPO)** approaches it from the
professional-conduct side. Its [position on AI in therapy](https://crpo.ca/resources/ai-therapy/)
is direct: if an RP uses AI to create or summarize notes, develop proposed treatment plans, or
recommend AI products to clients, the RP is responsible for meeting all the usual CRPO
requirements. That means providing services only within your competence, protecting privacy,
obtaining consent, and reviewing AI outputs using your own judgment.

Read those two together and the picture is clear. The AI can draft. You remain accountable for
consent, for privacy, and for the accuracy of anything that ends up in the record. The tool
does not absorb any of your professional responsibility.

## What changes in Quebec

Quebec is a different regime. If you practice there, or your clinic crosses both provinces, the
differences are worth knowing.

Quebec's Law 25 governs how private-sector organizations handle personal information, with
duties that touch AI directly. When a decision relies on automated processing of personal
information, the organization has to tell the person and, on request, explain the processing —
and consent has to be clear and specific. It's not enough that a client knows AI is in the
room; they need to understand how their information will be processed. Law 25 also expects a
privacy impact assessment in higher-risk situations, and the penalties aren't symbolic.
(Confirm exact section references and current penalty figures with your own counsel; specifics
here come from legal commentary, not the statute directly.)

On the health side, Quebec has a more formal path. The province's
[AI transcription program for health
professionals](https://www.quebec.ca/sante/professionnels/programme-transcription-intelligence-artificielle)
sets two requirements before an AI transcription tool can be used in health and social services
settings: TGV certification for the product, and a privacy impact assessment (EFVP) by the
acquiring organization. Santé Québec may complete EFVPs for its own context, but other
organizations still confirm their own obligations. The program also points clinicians to their
professional orders and is explicit about transparency: clients must be told AI is being used —
verbally at the start of a consultation or via a visible notice in the office — with the orders
recommending explicit consent.

The takeaway is simple: don't assume a tool that's acceptable in Ontario is cleared for Quebec.
Confirm its TGV status, the EFVP requirements, your professional-order guidance, and your
clinic's obligations first.

## A note on AI "therapy" versus AI documentation

Two things get blurred here. Using AI to help with documentation is a workflow and privacy
question. Using AI as a substitute for therapy is a different, more fraught issue, and CRPO has
been pointed about it: AI tools aren't regulated to provide therapy in Ontario, and treating
them as if they were carries real risks — privacy concerns, unhealthy dependence, and the
reinforcement of negative thinking. This post is about the first thing. The second deserves its
own careful conversation, and it's not one to hand to a chatbot.

## A practical checklist before you adopt any tool

If you are evaluating an AI notes tool, these are the questions worth answering first. They
apply to any vendor, ours included.

1. **Where does the data live?** Canadian data residency can reduce cross-border privacy
   complexity, but it does not make a tool compliant by itself. Confirm where audio and
   transcripts are stored.
2. **What is the consent flow?** You need a clean way to get explicit, understandable consent,
   and to offer a real alternative to clients who decline.
3. **Can you see and edit the draft before it is final?** You are reviewing the AI's output with
   your own judgment, so the workflow has to make that the default, not an afterthought.
4. **What happens to the audio?** Ask whether recordings are retained, for how long, and whether
   you can turn retention off.
5. **Can the vendor produce documentation?** Privacy impact assessments, security posture, audit
   logs, and a data processing agreement. If a vendor cannot show you these, that is your answer.
6. **Does it fit your province?** Ontario and Quebec have different expectations. Confirm the tool
   actually meets the one you practice under.

## What this looks like in practice

To make it concrete, here's roughly how the workflow runs on Ignia — one example of building
these requirements into the day-to-day rather than treating them as paperwork.

Consent is the part most tools treat as an afterthought, so it's where Ignia starts. It lives
in its own module inside a customizable intake form the client completes online, on their phone
if they want, before they come in. If consent isn't captured as a session approaches, the
platform flags it to the clinician beforehand; if it still needs to happen in the moment, the
therapist can capture and record it in a single click. The responsible step is built into the
normal flow, not left to memory.

The rest follows. The session is transcribed, the platform drafts a note in your preferred
format, and you review and edit that draft before it's saved — so the final note is yours, not
the model's. The transcript is processed by an AI model provider to produce the draft, while
the stored record stays in Canada, with an audit trail of who accessed what.

The goal is to make the responsible path the default. For any AI notes tool you evaluate,
[Ignia](https://www.getignia.com/) included, that's the standard to look for: consent before
use, clinician review before charting, clear retention settings, and documentation you can rely
on. The tools that hold up are the ones that make the responsible path the easy one.

## Frequently asked questions

**Can therapists in Ontario use AI to write clinical notes?**
Yes. CRPO's guidance allows registrants to use AI to help create or summarize notes, as long
as the registrant works within their competence, protects privacy, obtains consent, and reviews
the AI's output with their own judgment. The responsibility stays with the clinician.

**Do clients have to consent to an AI scribe?**
Yes, and consent should be explicit and understandable, not buried in a long form. A client who
declines should still receive the same standard of care, so you need a real alternative. In
Quebec, professionals must also inform clients that AI is being used.

**Is a tool that is approved in Ontario automatically allowed in Quebec?**
No. Quebec has its own path, including TGV certification for the product and a privacy impact
assessment (EFVP) by the acquiring organization. Confirm a tool's Quebec status separately
rather than assuming Ontario acceptance carries over.

**Does the AI make the final clinical note?**
It should not. The note the AI produces is a draft. The clinician reviews and edits it before it
becomes part of the record, and the clinician remains accountable for what is charted.

**What should I check before adopting an AI notes tool?**
Where the data is stored, the consent flow and the alternative for clients who decline, whether
you can edit the draft before it is saved, what happens to the audio, whether the vendor can
produce privacy and security documentation, and whether the tool meets your province's specific
requirements.

## Sources

- Information and Privacy Commissioner of Ontario, [*AI Scribes: Key Considerations for the
  Health Sector*](https://www.ipc.on.ca/en/resources/ai-scribes-key-considerations-health-sector)
  and the [companion
  checklist](https://www.ipc.on.ca/en/resources/ai-scribes-checklist-key-considerations-health-sector)
  (January 28, 2026).
- Information and Privacy Commissioner of Ontario, [news release on the AI scribes
  guidance](https://www.ipc.on.ca/en/media-centre/news-releases/ipc-releases-new-guidance-ai-scribes-help-protect-patient-privacy)
  (January 28, 2026).
- College of Registered Psychotherapists of Ontario, [*AI
  Therapy*](https://crpo.ca/resources/ai-therapy/).
- Gouvernement du Québec, [AI transcription program for health
  professionals](https://www.quebec.ca/sante/professionnels/programme-transcription-intelligence-artificielle).

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*This article is general information, not legal or compliance advice. Privacy law and college
expectations change, and they differ by province and profession, so confirm the current
requirements that apply to your practice before you act on them.*
