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(SAMPLE FOR LICENSED GRADUATE PROFESSIONAL COUNSELORS) PROFESSIONAL DISCLOSURE STATEMENT In accordance with the Annotated Code of Maryland, Health Occupations, 17-308, Authority granted by license,

How to fill out professional disclosure statement form

1. First, gather all the necessary information that will be included in the professional disclosure statement, such as your full name, contact information, professional qualifications, licenses, certifications, and areas of expertise.
2. Next, carefully review any guidelines or requirements provided by the relevant governing body or organization that oversees your profession. This will ensure that you include all necessary information and that your disclosure statement meets the necessary standards.
3. Start the professional disclosure statement with a clear and concise introduction, stating your intent to disclose relevant professional information. This section should also include a brief overview of your professional background and experience.
4. Create separate sections or headings for each aspect of your professional disclosure. For example, you may want to include sections for education and training, professional affiliations, work experience, specific skills or areas of specialization, and any additional certifications or licenses.
5. Under each section, provide the relevant details in a clear and organized manner. Include the dates, names of institutions or organizations, and any relevant qualifications or achievements.
6. Make sure to use professional language and avoid any unnecessary jargon or technical terms that may not be easily understood by readers who are not familiar with your field.
7. As you fill out the professional disclosure statement, remember to be thorough yet concise. Provide enough information to give readers a comprehensive understanding of your professional background, but avoid unnecessary details that may bog down the document.
8. Double-check your disclosure statement for accuracy and completeness. Review the document for any spelling or grammatical errors, and ensure that all the information is up to date.
9. Once you have completed filling out the professional disclosure statement, consider having a trusted colleague or mentor review it for feedback and suggestions. This can help ensure that the document effectively communicates your professional qualifications.
10. Finally, keep a copy of the completed professional disclosure statement for your records. Make sure to update the document as needed, especially when you acquire new qualifications or experiences in your professional career.

Who needs a professional disclosure statement may vary depending on the profession or industry. Generally, professionals who provide services that require a certain level of expertise or qualifications, such as doctors, lawyers, therapists, financial advisors, or consultants, may be required or recommended to have a professional disclosure statement. It is important to consult with the relevant governing bodies or organizations in your field to determine if a professional disclosure statement is necessary and what specific information should be included.

People Also Ask about

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 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 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

Which ORS describes what a professional disclosure statement must include?

ORS 675.755 - Professional disclosure statement required.

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

Which of the following should be included in a professional disclosure statement?

What is the The Professional Disclosure Statement? The name, title, business address, and business telephone number of the professional clinical counselor, professional counselor,

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What is professional disclosure statement?

A professional disclosure statement is a document that provides important information about a person's professional background, qualifications, and potential conflicts of interest.

Who is required to file professional disclosure statement?

Certain professionals, such as financial advisors, lawyers, and doctors, are required to file a professional disclosure statement.

How to fill out professional disclosure statement?

To fill out a professional disclosure statement, one must provide accurate and detailed information about their professional background, qualifications, and any potential conflicts of interest.

What is the purpose of professional disclosure statement?

The purpose of a professional disclosure statement is to provide transparency and ensure that clients or stakeholders are informed about a professional's background and any potential conflicts of interest.

What information must be reported on professional disclosure statement?

Information that must be reported on a professional disclosure statement includes professional qualifications, affiliations, conflicts of interest, and any other relevant information.