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Charla ChenowethSwift, MSW, LCSW Las Animas County Department of Human Services 135 E. Main Street, Suite 8 Phone: (719) 4227079PROFESSIONAL DISCLOSURE & INFORMED CONSENT STATEMENTWhat you should
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Obtain the v04072023 form from the appropriate source.
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Review the instructions provided with the form carefully.
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Fill in your personal information in the designated sections, including name and contact details.
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Complete the professional background section, detailing your qualifications and experience.
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Disclose any relevant financial interests or conflicts of interest as required.
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Include any licensing or certifications you hold in the specified area.
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v04072023 - professional disclosure is a document that professionals are required to submit to disclose relevant information about their qualifications, experience, and any potential conflicts of interest.
Professionals in regulated fields, such as healthcare providers, legal advisers, and financial consultants, are typically required to file v04072023 - professional disclosure.
To fill out v04072023 - professional disclosure, individuals must provide accurate personal and professional details, including qualifications, work history, and any potential conflicts of interest in the designated sections of the form.
The purpose of v04072023 - professional disclosure is to promote transparency and integrity within professional fields by ensuring that practitioners disclose essential information that could affect their professional standing.
Essential information required on v04072023 includes personal identification details, qualifications, professional experience, licensing information, and any potential conflicts of interest.
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