1. (1) The following information must be printed on all disclosure statements provided to counseling clients in language that can be easily understood by the client:

   1. (a) Name of firm, agency, business, or substance use disorder professional's practice.
   2. (b) Employment address and telephone number.
   3. (c) Name, credential, and credential number.

   4. (d) Billing information, including:

      1. (i) Client's cost per each counseling session;
      2. (ii) Billing practices, including any advance payments and refunds.
   5. (e) A list of the acts of unprofessional conduct in RCW 18.130.180 including the name, address, and contact telephone number within the department of health.
2. (2) A substance use disorder professional trainee must provide all the information required in subsection (1) of this section as well as their approved supervisor's name, credential number, and contact information.
3. (3) The substance use disorder professional or substance use disorder professional trainee and the client must sign and date a statement indicating that the client has been given a copy of the required disclosure information, and the client has read and understands the information provided.

[Statutory Authority: RCW 18.205.060, 43.70.250, chapter 18.205 RCW, 2023 c 425, 2024 c 371, and 2024 c 366. WSR 25-07-024, s 246-811-100, filed 3/10/25, effective 5/30/25. Statutory Authority: 2019 c 444, 2019 c 446, 2019 c 351, and RCW 18.19.050, 18.205.060, 18.225.040, 43.70.110, and 43.70.250. WSR 20-12-074, § 246-811-100, filed 6/1/20, effective 7/2/20. Statutory Authority: Chapter 18.205 RCW. WSR 09-14-111, § 246-811-100, filed 6/30/09, effective 7/1/09. Statutory Authority: RCW 18.205.060(15). WSR 00-12-102, § 246-811-100, filed 6/7/00, effective 7/8/00.]