Required for LCPC's and LCPC-c's only in the State of Maine. However, I think LCSW's and LMFT's would benefit from this document, as well. It helps the client get a snapshot of your credentials, training, clinical focus etc. to ensure a good match. Also, additional information is provided that is essential to the business part of private practice. This form can be edited to match you personally. Sections are all included for your reference. Other areas are written out for you so you do not need to spend the time formulating professional statements.