Disclosure and Release Forms

Consistent with the 2010 Code of Professional Ethics for Rehabilitation Counselors, the use of professional disclosure forms are now required. Specifically, Standard A.3.a states, "Rehabilitation counselors have an obligation to review with clients orally, in writing, and in a manner that best accommodates any of their limitation, the rights and responsibilities of both rehabilitation counselors and clients..."  The Standard further describes issues that should, at a minumum, be included.

CRCC offers sample professional disclosure forms and release statements, however, the forms below require review for applicability and modifications must be made as appropriate. Revisions for releases may also be required based on various laws or based on HIPAA requirements for transfer of medical records.

CRCC continually reviews the sample disclosure forms provided and welcomes your feedback. Please feel free to email your comments and/or recommendations to info@crccertification.com.

Disclosure Form - Private Sector - Forensic

View or Print Forensic Disclosure Form

Disclosure Form - Private Sector - Workers’ Comp/LTD

View or Print Workers’ Comp/LTD Disclosure Form

Disclosure Form - Public Sector

View or Print Public Sector Disclosure Form

Technology and Distance Counseling Checklist

View or Print Technology and Distance Counseling Checklist

Release of Information

View or Print Release of Information

Release for Information

View or Print Release for Information