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Del Morrill, M.S. C.C.H


A Center for Counseling & Hypnosis
Tacoma, Washington, USA
(253) 752-1506

Disclosure Statements


         What is a disclosure statement, and is it really necessary?  I’ve heard some therapists talk about having their clients sign such, but I don’t, as yet, have anything.  Do you have any sample that I could look at to determine how to word mine.    

           The disclosure statement I give to every client on their first visit is based upon what our State asks of any counselor or hypnotherapist.  It's important to check out your own state's requirements and adapt accordingly.  Personally, whether your state requires it or not, it’s a good idea, for it shows your professionalism, and it reminds your clients of their rights.

     Mine is in two basic parts - On the front are assurances, guidelines and confidentialty reminders; the back of gives my training, qualifications and the methods I use in my work.       The front of the page gives the cost of sessions and length of time for each and when evaluation of the work is to be done.  The statement includes (1) assurance that in no way will the client be made to do or say anything against their will or ethics during sessions. (2) They are free to halt therapy at any time should they become dissatisfied with treatment.  (3) The client is reminded of total confidentiality with exception of state requirements. (In Washington State, we must report suspected serious criminal activity and abuse of children.) The statement concludes with our guidelines regarding last-minute cancellations and no-shows, and agreement to pay for those.  At the bottom of the sheet, there is room for their signature, the date, and my own signature.  In the case of a child, the disclosure statement is edited appropriately to working with children. It is to be signed by the parent or guardian and the child, where possible, and myself.





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