Get Professional Disclosure Statement

This guide provides clear, step-by-step instructions for completing the Professional Disclosure Statement online. Whether you are a licensed graduate professional counselor or in training, this document is essential for outlining your qualifications and services to clients.

Follow the steps to complete your Professional Disclosure Statement online.

1. Press the ‘Get Form’ button to access the Professional Disclosure Statement and open the document in your preferred online editor.
2. In the first section, enter your full name, followed by your qualifications and titles, such as Licensed Graduate Professional Counselor.
3. Indicate the name of your counseling agency or practice, along with the street address, city, state, and zip code.
4. Provide your contact information, including your phone number, fax number (if applicable), and email address.
5. For the education section, list your highest degree obtained, the program of study, and the name of the university you attended.
6. In the supervision section, include the name of your clinical supervisor, their qualifications, and the licensing information as required.
7. Outline your fee schedule, specifying the types of services provided and their associated costs or hourly rates.
8. Review all entered information for accuracy and clarity before proceeding.
9. Once you have completed the form, choose to save your changes, and decide whether to download, print, or share the document as needed.

Complete your Professional Disclosure Statement online today to ensure clarity and professionalism in your counseling practice.