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STATEMENT OF INTENT Name___ Licensed Associate Counselor (LAC)___ Licensed Associate Marriage & Family Therapist (LA MFT)___ Board Approved Supervisor Status (LAC)___ Setting of My Practice: Private
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How to fill out professional disclosure statement pds

01
Include your name, license number, contact information, and professional credentials at the beginning of the statement.
02
Disclose any relevant education or training that informs your practice.
03
Provide information about your theoretical orientation and approach to therapy.
04
Include details about your fees, billing practices, and any insurance you accept.
05
Outline your confidentiality policies and practices.
06
Include information about your office policies, such as appointment scheduling, cancellation policy, and emergency procedures.
07
Provide information about your professional affiliations and any ethical guidelines you adhere to.

Who needs professional disclosure statement pds?

01
Psychologists
02
Therapists
03
Social workers
04
Counselors
05
Psychiatrists
06
Any professionals providing therapeutic services to clients
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Professional Disclosure Statement (PDS) is a document that provides information about a professional's background, qualifications, experience, and conflicts of interest.
Professional who are required to file a PDS include doctors, lawyers, financial advisors, and other professionals who provide services to clients.
Professional can fill out a PDS by providing accurate and complete information about their professional background, qualifications, experience, and any potential conflicts of interest.
The purpose of a PDS is to provide clients with transparency and information about the professional they are working with, helping them make informed decisions.
Information that must be reported on a PDS typically includes educational background, professional licenses, affiliations, and any potential conflicts of interest.
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