Get the free ADOLESCENT LPC Professional Disclosure Statement NCBLPC.docx

LPC Professional Disclosure Statement Ciepcielinski Counseling, LLC President, Emily Ciepcielinski, Ph.D., LPC 6809 Fairview Rd Suite A Charlotte, NC 28210 980.500.9260Qualifications: Dr. Ciepcielinski

How to fill out adolescent lpc professional disclosure

How to fill out adolescent lpc professional disclosure

1. To fill out an adolescent LPC professional disclosure, follow these steps:
2. Begin by gathering all the necessary information, including the therapist's name, contact details, and license information.
3. Provide a brief introduction about yourself, highlighting your qualifications, experience, and areas of expertise in working with adolescents.
4. Clearly state the purpose of the professional disclosure, which is to inform the adolescent and their parents/legal guardians about the therapy process, confidentiality, and professional boundaries.
5. Include information about the therapeutic techniques and approaches you use, emphasizing their effectiveness in treating adolescent clients.
6. Explain the limits of confidentiality, emphasizing the importance of maintaining privacy while also highlighting situations where confidentiality may need to be breached, such as when there is a risk of harm to self or others.
7. Include details about fees, payment methods, cancellation policies, and potential insurance coverage.
8. Provide information about your availability, including office hours and emergency contact procedures.
9. Outline the client's rights and responsibilities, ensuring they understand their role in the therapeutic process.
10. Include any additional relevant information, such as your credentials, affiliations, and any specializations related to adolescent therapy.
11. Conclude the disclosure with a statement encouraging the adolescent and their parents/legal guardians to ask any questions or seek clarification.
12. Finally, sign and date the disclosure to indicate its validity.
13. Make sure to review the completed disclosure for accuracy before providing it to the adolescent and their parents/legal guardians.

Who needs adolescent lpc professional disclosure?

1. Adolescent LPC professional disclosure is needed by licensed professional counselors (LPCs) who specialize in providing therapy services to adolescents.
2. This disclosure is necessary for any adolescent client entering therapy with an LPC as it serves to inform both the client (adolescent) and their parents/legal guardians about the therapist's qualifications, the therapy process, confidentiality, boundaries, and other important aspects.
3. It helps establish trust, sets clear expectations, and ensures that all parties involved are aware of their rights and responsibilities in the therapeutic relationship.
4. Therefore, any adolescent seeking therapy from an LPC and their parents/legal guardians should receive and review the professional disclosure as part of the intake process.

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What is adolescent lpc professional disclosure?

Adolescent LPC professional disclosure is a document that LPC professionals working with adolescents must file to disclose certain information about their practice.

Who is required to file adolescent lpc professional disclosure?

LPC professionals who work with adolescents are required to file adolescent LPC professional disclosure.

How to fill out adolescent lpc professional disclosure?

Adolescent LPC professional disclosure can be filled out by providing the required information about the LPC professional's practice with adolescents.

What is the purpose of adolescent lpc professional disclosure?

The purpose of adolescent LPC professional disclosure is to provide transparency and ensure that LPC professionals working with adolescents are abiding by certain regulations and guidelines.

What information must be reported on adolescent lpc professional disclosure?

Information such as the LPC professional's contact information, qualifications, areas of expertise, and any disciplinary actions must be reported on adolescent LPC professional disclosure.