Pennsylvania Statutes Title 63 P.S. Professions and Occupations (State Licensed) § 1920.1. Disclosure

(1) The name, title, business address and business telephone number of the marriage and family therapist or professional counselor providing services.

(2) The formal professional education of the marriage and family therapist or professional counselor, including the institutions attended and the degrees received.

(3) The marriage and family therapist's or professional counselor's professional philosophy and approach to treatment, services provided and professional credentials held.

(4) In the case of marriage and family therapists or professional counselors engaged in a private individual practice, partnership or group practice, the fee schedule listed by type of service or hourly rate.

(5) At the end of the disclosure statement, the sentences “This information is required by the Board of Social Workers, Marriage and Family Therapists and Professional Counselors, which regulates marriage and family therapists and professional counselors.”

(6) Immediately beneath the statement required by paragraph (5), the name, address and telephone number of the board.