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PDS Credit Waiver Request Form OHIO Center for Clinical Practice in Education 125A McCracken Hall Athens, Ohio 45701 Application for Graduate Tuition/Fee Waiver 20222023 NOTE: Please refer to The
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Start by obtaining a template or form for the professional disclosure statement (PDS) from your licensing board or regulatory agency.
02
Fill in your personal information such as name, contact details, and professional title.
03
Provide a brief background and summary of your educational and professional qualifications.
04
Disclose any relevant previous work experience and areas of expertise.
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Include information about your practice policies, such as fees, scheduling, and confidentiality.
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Clearly state your approach to treatment and any specific therapeutic modalities you use.
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Review the completed PDS for accuracy and ensure it complies with any regulations or guidelines set forth by your licensing board.

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Professional Disclosure Statement (PDS) is a document that provides information on a professional's background, qualifications, and relationships that could potentially create conflicts of interest.
Professionals such as financial advisors, lawyers, accountants, and consultants are typically required to file a Professional Disclosure Statement (PDS) as part of regulatory requirements.
To fill out a Professional Disclosure Statement (PDS), individuals must provide accurate information about their qualifications, affiliations, and any potential conflicts of interest that may exist.
The purpose of a Professional Disclosure Statement (PDS) is to increase transparency and trust by providing clients or stakeholders with relevant information about a professional's background and potential conflicts of interest.
Information such as educational background, work experience, affiliations with other organizations, and any potential conflicts of interest must be reported on a Professional Disclosure Statement (PDS).
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