Professional Disclosure Statement (PDS)
Basic Requirement
The professional disclosure statement (PDS) is a document that an LPC, LMFT, or registered associate gives to each client that provides information about the licensee/registered associate and their practice.
Who must have a PDS?
Every applicant for licensure must submit a PDS as part of his or her application.
Every LPC, LMFT, and registered associate practicing in Oregon must have, maintain and distribute a PDS unless granted a waiver from the Board.
The Board must approve all PDSs.
PDS Content
Name, business address and telephone number (place or places of practice);
Philosophy and approach, including codes of ethics followed and list of the Client Bill of Rights;
Formal education and training, including name of highest degree, school, and major coursework;
Continuing education requirements (licensees only);
Supervision requirements and registered associate status, including name of supervisor (registered associates only);
Fee schedule a dollar amount or dollar range;
Name, address, phone number, email, and website address of the Board; and
A statement that additional information about licensee or registered associate is available on the Board’s website.
Please refer to OAR 833-075-0050 (Licensees) or OAR 833-050-0031 (Registered Associates).
Sample PDS Documents
Sample Registered Associate PDS
Registered Associate PDS Fillable Form (optional)
Sample Licensee PDS
Licensee PDS Fillable Form (optional)
PDS Distribution
To the Board office for approval. Upload the document via the Licensee Portal (or for new applicants, the initial PDS is submitted via the Applicant Portal). Click here for more information about the portals.
To all clients at the onset of counseling or therapy, prior to the actual performance or provision of service. This may mean presentation to parent, legal guardian, or an agency or custodial institution, or a supervisee.
No PDS is required of those who have been granted a good cause waiver by the Board.
PDS Waiver Request Form