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
HRV Biofeedback Certification
Neurofeedback Certification
Pelvic Muscle Dysfunction Biofeedback Certification
Why Choose BCIA Pelvic Muscle Dysfunction Biofeedback 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
Online Payment Options
Is There a State/Regional Biofeedback Society Near you?