PROFESSIONAL DISCLOSURE STATEMENT
Nicole Rennix, MA, LMFT
CA License #144057 OR License #T1939
1095 Hilltop Drive #608, Redding, CA 96003
(707) 656-3736 email@example.com
Philosophy and Approach:
I am a sex-positive, identity-affirming therapist who believes that each client is the master of their own life. I use a solution-oriented approach that begins with identifying what is already working and collaborating with clients to determine where to go from there. I draw upon humanistic-existential and Buddhist philosophies, and I incorporate somatic awareness and the practice of approaching things with open curiosity.
Formal Education and Training:
I hold a master’s degree in transpersonal counseling psychology from John F. Kennedy University. I sought LGBTQ-specific training, beginning with my practicum at Pacific Center for Human Growth, the oldest LGBTQ center in California. My continuing education focuses on gender, sexual, and relationship diversity, neurodivergence, and the intersections thereof.
As a Licensee of the Oregon Board of Licensed Professional Counselors and Therapists: I abide by its Code of Ethics. To maintain my license, I am required to participate in continuing education, taking classes dealing with subjects relevant to this profession.
My session fees are $225 per 45 minutes. Payments are charged to the client’s/responsible party’s credit/debit card via my Client Portal at the time of service. While I do not accept insurance, upon your request, I will provide statements that you can submit to your insurer for potential reimbursement.
As a client of an Oregon licensee, you have the following rights:
- To expect that a licensee has met the qualifications of training and experience required by state law
- To examine public records maintained by the Board and to have the Board confirm credentials of a licensee
- To obtain a copy of the Code of Ethics (Oregon Administrative Rules 833-100)
- To report complaints to the Board
- To be informed of the cost of professional services before receiving the services
- To be assured of privacy and confidentiality while receiving services as defined by rule or law, with the following exceptions:
- Reporting suspected child abuse
- Reporting imminent danger to you or others
- Reporting information required in court proceedings or by your insurance company, or other relevant agencies
- Providing information concerning licensee case consultation or supervision
- Defending claims brought by you against me
- To be free from discrimination because of age, color, culture, disability, ethnicity, national origin, gender, race, religion, sexual orientation, marital status, or socioeconomic status
For additional information, you may contact the Board of Licensed Professional Counselors and Therapists at:
3218 Pringle Rd. SE, Ste. 120, Salem, OR 97302-6312 Telephone: (503) 378-5499 Email: firstname.lastname@example.org Website: www.oregon.gov/OBLPCT