Mine did, and I did have to sign off. Canada tho, public health care,so I wasn't seeking out therapy on my own or privately. I think I would not have had to sign off it that had been the case tho.

What seems weird is when she said " patients felt empowered by being compelled to sign off on this".... Really? How would that be empowering?

Compelled...
1. To force, drive, or constrain

2. To necessitate or pressure by force

3. To exert a strong, irresistible force on; sway

Hmm sounds empowering... I would ask her to clarify what she meant by empowered. Not only that.. her telling you that other patients felt empowered and compelled to do so seems manipulative.. reads like the definition of compelled. And maybe that is why they felt compelled, plus she said demand, not request. I can see why you feel uneasy about it.