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Professional Ethics Declaration:

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If you answered "yes" to any of the above items, please list below each instance, describing briefly the events leading up to the case, the outcome and its relevance to the practice of psychology. This information will be kept confidential. Failure to complete all questions and statements may result in a delay of application processing.

By submitting this form, I certify that I have read and I agree to abide by the Code of Ethics of the American Psychological Association. I also certify that all information on this form and any attached forms is true to the best of my knowledge.

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