PROFESSIONAL DISCLOSURE STATEMENT Clause Samples
A Professional Disclosure Statement is a clause that outlines the qualifications, credentials, and professional background of the individual or entity providing services under the agreement. It typically includes information such as licenses held, areas of expertise, and any relevant affiliations or certifications, ensuring that the client is fully informed about the provider’s professional standing. This clause serves to promote transparency and trust by clearly communicating the provider’s qualifications, thereby helping clients make informed decisions and reducing the risk of misunderstandings regarding the provider’s capabilities.
PROFESSIONAL DISCLOSURE STATEMENT. I acknowledge that I have received the Professional Disclosure Statement I acknowledge that I have received the Fee Schedule and Litigation Related Services information and have reviewed the information contained therein. I understand that insurance is billed as a courtesy and that I am responsible for full payment of all services provided regardless of my insurance coverage. I agree that I, as the guarantor, am responsible for payment of all services regardless of any court ordered financial agreements; it is my responsibility to collect from other parties.
PROFESSIONAL DISCLOSURE STATEMENT. ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇, MS, LPC
PROFESSIONAL DISCLOSURE STATEMENT. The Broadway Counseling Center is committed to offering the highest quality of counseling services to the community. My name is ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇. I have a Master’s degree in Marriage and Family Therapy from Abilene Christian University and am completing the licensure requirements as a Licensed Marriage and Family Therapy Associate in the state of Texas. I am also in the process of completing my Ph.D. in Couple, Marriage, and Family Therapy at Texas Tech University. I work with individuals, couples, and families across the lifespan dealing with various issues in their lives. Although I am capable of handling a variety of problems, there may be situations that I will recommend you to another specialized therapist or professional so you will be better served. Please note that I am not a Psychiatrist, (who is a medically trained doctor), so I am unable to prescribe medication. Also, I am not a Licensed Psychologist, and I am unable to administer certain diagnostic tests. Further, I do not provide custody evaluations, and if you require this service, I will provide you with a referral to a professional equipped to do so. My most common intervention strategies stem from Trauma-Focused Cognitive Behavioral Therapy and Experiential Therapy. Both of these approaches are evidence-based, maintain the focus of therapy sessions on the present, and draw on clients’ strengths as resources for therapeutic change. In my practice, I believe emotional wounds and lack of safety and security in our relationships are the sources of both personal and relationship problems. I believe our brains first have an emotional reaction to various triggers in our relationships, and these emotional reactions shape our thoughts and behaviors. I also believe people have the strengths and resources they need to solve their problems, and their distress comes as a result of being stuck in old, vicious cycles of interaction. Thus, a primary goal of therapy is to restructure important relationships into patterns of trust, safety, security, and acceptance. Additionally, successful therapy depends on maintaining secure, trusting connection between clients and myself, and it is my goal to help my clients also ▇▇▇▇▇▇ honest, secure, and trusting relationships with one another. Because of this, I do not feel comfortable keeping secrets between myself and others in your family, and my process is to always help you find ways to disclose those issues to your spouse, if married, or other family members. My ...
PROFESSIONAL DISCLOSURE STATEMENT. The therapists and supervisors at The ▇▇▇▇▇▇ Institute, Inc. are committed to offering affordable, high quality therapeutic services to the community. We are dedicated to helping meet the mental health and relationship care needs of individuals, couples, and families and to the post-master’s supervision of skilled, pre-licensed marriage and family therapists. There are two types of therapists at the Institute: Licensed Marital and Family Therapists (LMFT) and Pre-Licensed Clinical Fellows. An LMFT is any person who has met the qualifications for licensed marital and family therapist and holds a current, unsuspended or unrevoked, license which has been lawfully issued by The Board for Professional Counselors, Marital and Family Therapists, and Clinical Pastoral Therapists in Tennessee. After graduating with a master’s degree, all therapists seeking licensure in Tennessee are required to spend at least two years gaining post-graduate clinical experience and ongoing supervision. This stage of therapists' careers is similar to when medical doctors graduate and spend several years in a residency program. The pre-licensed clinical fellows at The ▇▇▇▇▇▇ Institute, Inc. have taken this step in their careers and are currently earning the post-graduate experience required for independent licensure. Pre-licensed clinical fellows at the Institute provide mental health and relationship care services under the supervision of AAMFT Approved Supervisors. This designation signifies that these supervisors have "...attained the educational, experiential and supervisory training required for the competent supervision of marriage and family therapists and trainees." This places the pre-licensed clinical fellows at the Institute under the mentoring of clinicians who have earned the highest supervision designation in the mental health field. To learn more about AAMFT approved supervision, visit ▇▇▇.▇▇▇▇▇.▇▇▇. Therapy experiences vary depending on the personalities of the therapist and client(s) and the particular problems being addressed. There are many different methods that may be used to deal with the problems that you hope to focus on. Visiting a therapist is not like a visit to a medical doctor. Rather, it calls for a very active effort on the part of the client(s). In order for therapy to be most successful, you will have to work on things at home that are talked about during your sessions. Therapy has both risks and benefits. Since therapy often involves discussing unplea...
PROFESSIONAL DISCLOSURE STATEMENT. ▇▇. ▇▇▇▇▇▇▇ ▇▇▇▇▇