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CONSENT FOR RELEASE OF INFORMATION Client Name: Client D.O.B. I, (name of authorizing party), authorize Nancy Asher, LPC, NCC, Registered Play Therapist to disclose and/or obtain information about
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Anyone looking to become a professional counselor or seeking certification in counseling.
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Counseling associations or licensing boards that use this form to assess the qualifications and competencies of counselors.
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Form professional counselors desk is a regulatory form used by professional counselors to report their professional activities, client information, and compliance with state regulations.
Licensed professional counselors and those practicing under state requirements must file the form to maintain their licensure.
To fill out the form, counselors must provide their personal details, license number, professional activities, and any required disclosures according to the instructions provided with the form.
The purpose of the form is to ensure compliance with state regulations, track the professional activities of counselors, and maintain standards within the profession.
Counselors must report their personal contact information, licensure details, professional activities, continuing education credits, and any ethical or legal issues encountered.
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