NC Licensed Professional Counselor Professional Disclosure Statement 2016-2025 free printable template

C. Grace Hodgson, MA, LPC, NCC Licensed Professional Counselor Main Office: (980) 3953062 Direct Line: (980) 7776005 Fax: (980) 3217164 Professional Disclosure Statement Qualifications: I am a Licensed

How to fill out professional disclosure statement examples form

How to fill out NC Licensed Professional Counselor Professional Disclosure Statement

1. Obtain the NC Licensed Professional Counselor Professional Disclosure Statement template from the North Carolina counseling board or a reliable source.
2. Fill in your full name, license number, and contact information at the top of the statement.
3. Provide a brief description of your professional qualifications, including education and training relevant to counseling.
4. Include a section that outlines your counseling approach and techniques, explaining how you typically work with clients.
5. Clearly state your fees and the payment policies, including information about insurance if applicable.
6. Discuss confidentiality policies and the limits of confidentiality, ensuring clients understand what to expect.
7. Add information about the client's rights and responsibilities in the counseling process.
8. Highlight the process for clients to file complaints or grievance procedures.
9. Review the document for accuracy and clarity before finalizing it.
10. Provide the completed Disclosure Statement to clients before initiating counseling services, allowing them time to ask questions.

Who needs NC Licensed Professional Counselor Professional Disclosure Statement?

1. All licensed professional counselors providing mental health services in North Carolina are required to present the Professional Disclosure Statement to clients.
2. Clients considering counseling services to understand the counselor's qualifications, fees, and policies will benefit from the disclosure statement.

People Also Ask about professional disclosure statement counseling template

How do you tell a client about confidentiality?

A contract should outline all the limits of confidentiality in counselling and additionally should provide clarity about the way client notes are produced and stored, including the length of time they will be kept, and any circumstances in which they would be disclosed.

What is an example of counseling confidentiality statement?

Counselling is confidential. This means I will not share information about you with a third party unless you consent to that disclosure. So I will not tell anyone that you attend counselling, or what you say in our sessions, without your permission to do so.

What are the 4 types of self-disclosure?

There are five types of self-disclosures: deliberate, unavoidable, accidental, inappropriate and client- initiated.

What are the 3 types of counseling?

So, what are the three main types of counseling? Psychodynamic, humanistic, and behavioral approaches are the most common and each support different individual therapies.

What is an example confidentiality statement for counselors?

Counselling is confidential. This means I will not share information about you with a third party unless you consent to that disclosure. So I will not tell anyone that you attend counselling, or what you say in our sessions, without your permission to do so.

What is an example of a disclosure statement in counseling?

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 an example of self-disclosure in counseling?

For example; “I feel like you don't really want to be here today, why is that?” In most cases, this is the most useful type of self-disclosure at it's often used as a way of naming a process that's occurring during counselling.

What does disclosure mean in Counselling?

What is Self-Disclosure. Self-disclosure refers generally to a counselor's sharing of personal information to clients during or outside the counseling session.

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What is NC Licensed Professional Counselor Professional Disclosure Statement?

The NC Licensed Professional Counselor Professional Disclosure Statement is a document that provides clients with important information about the counselor's qualifications, services, and client rights.

Who is required to file NC Licensed Professional Counselor Professional Disclosure Statement?

All licensed professional counselors in North Carolina are required to provide a Professional Disclosure Statement to clients before starting counseling services.

How to fill out NC Licensed Professional Counselor Professional Disclosure Statement?

To fill out the Professional Disclosure Statement, counselors should include their qualifications, areas of practice, fees, confidentiality policies, and information about how to file complaints.

What is the purpose of NC Licensed Professional Counselor Professional Disclosure Statement?

The purpose of the Professional Disclosure Statement is to inform clients about the counselor's professional background, the nature of counseling services, and the client's rights, thereby fostering transparency and establishing trust.

What information must be reported on NC Licensed Professional Counselor Professional Disclosure Statement?

The statement must report the counselor's education, licenses, areas of expertise, treatment approaches, fees, cancellation policies, confidentiality limits, and contact information, among other relevant details.