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Professional Disclosure Statement Emily Compton M.S., CRC, LCM HCA Lewisville Family Counseling, LLC 6614 Shallow ford Rd, Ste 250, Lewisville NC 27023 Phone 3369450137 Fax 3369469084 Emily@lewisvillefamilycounseling.com

How to fill out lcmhca professional disclosure statement

How to fill out lcmhca professional disclosure statement

1. Include your name, credentials, contact information, and license number at the beginning of the document.
2. Outline the services you provide and how the client can communicate with you.
3. Detail your fees, insurance information, and any billing procedures.
4. Explain confidentiality policies and exceptions to confidentiality.
5. Provide information on the limits to confidentiality, such as mandated reporting requirements.
6. Include information on crisis intervention procedures and emergency contact information.
7. Have the client sign and date the document to acknowledge receipt and understanding.

Who needs lcmhca professional disclosure statement?

1. Licensed Clinical Mental Health Counselors (LCMHCAs) need to provide a professional disclosure statement to clients before beginning therapy sessions.

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What is lcmhca professional disclosure statement?

The LCMHCA professional disclosure statement is a document that therapists and counselors must provide to clients outlining their professional background, services offered, fees, confidentiality policies, and other important information.

Who is required to file lcmhca professional disclosure statement?

Therapists and counselors who are Licensed Clinical Mental Health Counselor Associates (LCMHCA) are required to file a professional disclosure statement with their clients.

How to fill out lcmhca professional disclosure statement?

Therapists and counselors can fill out the LCMHCA professional disclosure statement by including their personal and professional information, services offered, fees, confidentiality policies, and any other relevant information for clients.

What is the purpose of lcmhca professional disclosure statement?

The purpose of the LCMHCA professional disclosure statement is to inform clients about the therapist's background, services offered, fees, confidentiality policies, and other important information to ensure transparency and trust in the therapeutic relationship.

What information must be reported on lcmhca professional disclosure statement?

The LCMHCA professional disclosure statement must include the therapist's personal and professional information, services offered, fees, confidentiality policies, and any other relevant information for clients.