OAR 833-050-0031
Registered Intern Professional Disclosure Statement
(1)
Registered interns must furnish clients with a copy of a Board-approved professional disclosure statement (PDS) before providing counseling or therapy. When providing disclosure statements via electronic communication, interns must ensure a means of documenting confirmation of receipt and acknowledgement of the PDS.(2)
A professional disclosure statement must include the following information about the intern:(a)
Name, business address and telephone number;(b)
Name of the intern’s supervisor(s);(c)
Philosophy and approach to counseling or marriage and family therapy, including reference to any codes of standards or ethics to which the intern subscribes;(d)
Formal education and training, title of highest relevant degree, the school that granted the degree, and major coursework;(e)
Supervision requirements;(f)
A statement indicating adherence to the Oregon Licensing Board’s Code of Ethics set forth in OAR Chapter 833, Division 100;(g)
The standard fee for service, including discounted rates or sliding scale and a statement that no fees will be charged and no additional fee will be added to another set fee such as a hospital room daily charge;(h)
A bill of rights of clients, including a statement that consumers of counseling or therapy services offered by Oregon licensees have the right:(A)
To expect that an intern has met the minimum qualifications of training and experience required by state law;(B)
To examine public records maintained by the Board and to have the Board confirm credentials of an intern;(C)
To obtain a copy of the Code of Ethics;(D)
To report complaints to the Board;(E)
To be informed of the cost of professional services before receiving the services;(F)
To be assured of privacy and confidentiality while receiving services as defined by rule or law. Licensees must include an explanation of each exception to confidentiality;(G)
To be free from being the object of discrimination on any basis listed in the Code of Ethics while receiving services.(i)
The name, address, telephone number, and email address of the Oregon Board of Licensed Professional Counselors and Therapists; and(j)
A statement indicating the following: “Additional information about this registered intern is available on the Board’s website: www.oregon.gov/oblpct.”(3)
The professional disclosure statement must be accessible to people with disabilities.(4)
Registered interns will assist their clients to understand the information in the professional disclosure statement.(5)
Whenever an intern changes the professional disclosure statement, the new statement must be provided to the Board for approval.
Source:
Rule 833-050-0031 — Registered Intern Professional Disclosure Statement, https://secure.sos.state.or.us/oard/view.action?ruleNumber=833-050-0031.