Board of Professional Counselors Disclosure Statement Sec. 08.29.220. Disclosure statement. A client may not be charged a fee for professional counseling services unless, before the performance of services, the client was furnished a copy of a professional disclosure statement that contained the name, title, business address, and business telephone number of the professional counselor; a description of the formal professional education fo the professional counselor, including the institutions attended and the degrees received from them; the professional counselor's areas of specialization and the services available; the professional counselor's fee schedule listed by type of service or hourly rate; at the bottom of the first page of the statement, the following sentence: "This information is required by the Board of professional Counselors which regulates all licensed professional counselors," followed by the name, address, and telephone number of the board's office. Sample Disclosure Statement