Professional Disclosure Statement for Tamara G. SuttleM.ED.LPC 2012-2025 free printable template

This document outlines the professional credentials, therapeutic processes, rights, and responsibilities of clients seeking counseling services. It includes information on confidentiality, risks and

How to fill out disclosure suttle professional form

How to fill out Professional Disclosure Statement for Tamara G. SuttleM.ED.LPC

1. Gather all necessary personal and professional information, including your qualifications and experience.
2. Clearly state the services you provide as a counselor.
3. Include your licensing information and credentials.
4. Outline your approach to counseling and any special areas of expertise.
5. Explain the potential risks and benefits of counseling.
6. Discuss confidentiality and its limits, including situations where disclosure might be necessary.
7. Provide information on your fees, payment methods, and cancellation policies.
8. Ensure the document is clear, concise, and accessible to clients.

Who needs Professional Disclosure Statement for Tamara G. SuttleM.ED.LPC?

1. Clients seeking counseling services from Tamara G. Suttle, M.ED, LPC.
2. Individuals wanting to understand the counselor's qualifications and services.
3. Parents or guardians of minors seeking counseling.
4. Anyone interested in understanding the therapeutic relationship and its implications.

People Also Ask about professional disclosure statement tamara lpc

How do you write a professional disclosure statement?

I will keep confidential anything that you say to me, with the following exceptions: a) you direct me to tell someone else, b) I determine that you are a danger to yourself or others, c) I am ordered by a court to disclose information, d) I suspect or am made aware of physical/sexual abuse of minors, persons with

What is the professional disclosure statement?

The professional disclosure statement (PDS) is a document that an LPC, LMFT, or registered associate gives to each client that provides information about the licensee/registered associate and their practice. Who must have a PDS? Every applicant for licensure must submit a PDS as part of his or her application.

What is an example of a therapy disclosure statement?

I give my consent for treatment as outlined in this Disclosure Statement. I, the client, understand that I am free to terminate the treatment process at any time by giving appropriate notice with respect to the therapeutic relationship established and the cancellation policy mentioned above.

What is the informed consent and disclosure statement?

A Professional Counseling Informed Consent Form is a document provided by the counseling service to their clients in order to properly acquire consent from them treatment for mental health. The form contains information about the services and the agreement to be made by the counseling service and the client.

How do you write a disclosure statement for a therapist?

The following items are often included: Contact info. Your qualifications including training, experience, licensure and certifications. Professional associations that you belong to. Any limitations on your practice such as being under supervision. Services offered. Your theoretical foundation and counseling approach.

What is an example of a professional disclosure statement?

I will keep confidential anything that you say to me, with the following exceptions: a) you direct me to tell someone else, b) I determine that you are a danger to yourself or others, c) I am ordered by a court to disclose information, d) I suspect or am made aware of physical/sexual abuse of minors, persons with

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What is Professional Disclosure Statement for Tamara G. SuttleM.ED.LPC?

The Professional Disclosure Statement for Tamara G. Suttle, M.ED, LPC is a document that provides potential clients with important information about her qualifications, treatment approaches, and professional practices.

Who is required to file Professional Disclosure Statement for Tamara G. SuttleM.ED.LPC?

Tamara G. Suttle, as a licensed professional counselor, is required to file a Professional Disclosure Statement to comply with licensing regulations and to inform clients.

How to fill out Professional Disclosure Statement for Tamara G. SuttleM.ED.LPC?

To fill out the Professional Disclosure Statement, Tamara G. Suttle needs to include her credentials, therapy modalities, fees, confidentiality policies, and contact information.

What is the purpose of Professional Disclosure Statement for Tamara G. SuttleM.ED.LPC?

The purpose of the Professional Disclosure Statement is to enhance transparency between the counselor and clients, ensuring that clients understand the services provided and the counselor's qualifications.

What information must be reported on Professional Disclosure Statement for Tamara G. SuttleM.ED.LPC?

The information that must be reported includes her educational background, licenses, areas of expertise, treatment philosophies, and any relevant policies regarding confidentiality and fees.