PROFESSIONAL DISCLOSURE STATEMENT
IT IS REQUIRED THAT YOU RECEIVE THIS FORM IF RECEIVING SERVICES IN THE STATE OF LOUISIANA
THIS FORM ( AND OTHER PERTINENT INFORMATION) CAN BE FOUND AT WWW.LABSWE.ORG
All clients of a Licensed Clinical Social Worker in the state of Louisiana should:
1. Expect that the social worker has met the minimal qualifications of education, training, and experience required by state law;
2. Examine public records maintained by the board which contain the social worker's qualifications and credentials;
3. Be given a copy of the standards of practice upon request;
4. Report a complaint about the social worker's practice to the board;
5. Be informed of the range of fees for professional services before receiving the services;
6. Privacy as allowed by law, and to be informed of the limits of confidentiality;
7. Expect that the social worker will take reasonable measures consistent with the social worker's duty of confidentiality to limit access to client information and any expressed waivers or authorizations executed by the client. Reasonable measures include restricting access to client information to appropriate agency or office staff whose duties require such access. When providing services through distance therapy, reasonable measures include taking special safeguards with technology to protect client information;
8. Receive information that a social worker is receiving supervision and that the social worker may be reviewing the client's case with the social worker's supervisor or consultant. Upon request, the social worker shall provide the name of the supervisor and the supervisor's contact information;
9. Be free from being the object of discrimination while receiving social work services; and
10. Have access to records as allowed by law.
Please keep this for your files