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Monica Michael, LPC 5242 Plainfield Ave. NE, Suite C Grand Rapids, MI 495251084 Website: monicamichael.com 616.970.1599 Professional Disclosure Statement Description of Practice Monica Michael is
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Obtain a copy of the 2023 professional disclosure statement form.
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Fill in your personal information such as name, address, and contact information.
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Provide details about your professional background, including education, work experience, and any relevant certifications or licenses.
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Disclose any conflicts of interest or potential conflicts of interest that may arise in your professional work.
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Sign and date the form once it has been completed.

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Any professional who is required to disclose information about their background, qualifications, and potential conflicts of interest may need to fill out a 2023 professional disclosure statement. This could include employees in financial services, healthcare, or any other regulated industry.
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Professional Disclosure Statement 19 is a document required by certain professional organizations or regulatory bodies to disclose relevant information about a professional's qualifications, affiliations, and any potential conflicts of interest.
Typically, licensed professionals such as lawyers, accountants, therapists, and other regulated practitioners are required to file Professional Disclosure Statement 19 as part of their compliance with professional regulations.
To fill out Professional Disclosure Statement 19, individuals should gather their personal and professional information, including qualifications, licenses, and any affiliations, and then follow the specific instructions provided by the regulatory body or organization to complete the form.
The purpose of Professional Disclosure Statement 19 is to ensure transparency and accountability within professional practices by providing clients and relevant authorities with essential information about a professional's background and potential conflicts of interest.
Information that must be reported typically includes professional qualifications, licenses, areas of expertise, affiliations with other organizations, and any previous disciplinary actions.
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