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Jennifer Walker, MA, LPC 8307 Six Forks Road, Suite 201, Raleigh, NC 27615 cell: 9196734051 fax: 9197140897 SUPERVISED DISCLOSURE STATEMENT As we enter our relationship, I hope this document will
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01
To fill out Jennifer Walker supervisee disclosure, follow these steps:
02
Start by entering your personal information, such as your name, address, and contact details.
03
Indicate whether you are a supervisee or a supervisor.
04
Provide your license or certification information, including the issuing authority and expiration date.
05
Disclose any previous disciplinary actions or complaints filed against you.
06
Specify the types of counseling or therapy you provide and the populations you work with.
07
Declare any conflicts of interest or potential conflicts of interest you may have.
08
Indicate whether you have any financial arrangements or agreements related to your supervision.
09
Sign and date the disclosure form to certify its accuracy and completeness.

Who needs jennifer walker supervisee disclosure?

01
Jennifer Walker supervisee disclosure is required for individuals who are seeking supervision under the guidance of Jennifer Walker.
02
This may include counseling or therapy interns, trainees, or professionals who need supervision from Jennifer Walker.
03
Supervision is often required as part of the licensure or certification process in the field of counseling or therapy.
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The Jennifer Walker Supervisee Disclosure is a required form that provides necessary information about supervisees under the Jennifer Walker supervision framework, aimed at promoting transparency and accountability.
Individuals who are providing supervision to others under the Jennifer Walker framework are required to file the Jennifer Walker Supervisee Disclosure.
To fill out the Jennifer Walker Supervisee Disclosure, individuals must complete the specified form by providing accurate personal information about the supervisee, details of the supervision, and any relevant circumstances as required.
The purpose of the Jennifer Walker Supervisee Disclosure is to ensure that all relevant parties have access to information about the supervisees, aimed at ensuring adherence to professional standards and ethical guidelines.
The disclosure must include the supervisee's identification details, the nature of the supervision provided, any relevant training or certifications, and other information as mandated by the overseeing authority.
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