Sample Statement of Practice and Mentoring Letter

In order to apply for biofeedback certification by prior experience (CPE), your statement of clinical practice should include:

  • Timeframe using biofeedback in your clinical practice
  • Approximate number of patient/clients in that time frame (For example, as a way to calculate your hours, if you saw 20 clients for a one-hour session per week for 50 weeks a year, that would be 1,000 patient/client hours)
  • The diagnoses you treat
  • Setting (private practice, hospital, etc.)

An example of a proper statement is provided below:

"As a licensed occupational therapist, I was looking for a new tool to work with patients, children and adults diagnosed with elimination disorders. I began to add biofeedback to my practice in 1998. For the first 2 years, it was only about 20% of my practice or about 800 hours. My practice grew steadily through about 2005 and biofeedback was at least 50% of my practice during those years or about 6,000 hours. From 2006, I use biofeedback with at least 75% of my practice or about 1500 hours per year. I estimate that I have performed well over 10,000 hours of biofeedback."

Sample Letter of Recommendation

"I have read the statement of clinical practice for Dr. ________. I have known him/her for over 10 years and can agree with his/her account of his/her clinical work using biofeedback modalities."

A recommender may add any other statements that would be helpful for the board to review. For example:

"Additionally, I have referred several patients to Dr. ________ and we often consult on patients/clients. He/She was a member of the ________ state biofeedback society and we worked together on several presentations and other committee work. I have found him/her to be a competent clinician who has a good reputation in our health care community."

Applicants Start Here
Biofeedback Certification
Neurofeedback Certification
Pelvic Muscle Dysfunction Biofeedback Certification
Why Choose BCIA Pelvic Muscle Dysfunction Biofeedback Certification?
Clinical Certification
Entry-Level Certification
Certification by Prior Experience
Application Instructions
Sample Statement of Practice and Mentoring Letter
Anatomy and Physiology
Technician Certification
Didactic Training
Common Documents
HRV Certificate Program
Application Status