Profile - PSY.0002208 | |
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General Disclaimer: The information posted on the Healthcare Professions Profile Program (HPPP) website was provided by applicants for an original license; applicants for reinstatement or reactivation of an existing license; as well as by those individuals renewing a license. While the Division believes the information to be reliable, human or mechanical error remains a possibility, as does the delay in the posting or updating of information. The Division makes no guarantee as to the accuracy or completeness of the information and the information is not verified by the HPPP staff. The Division will take action to obtain compliance with the requirements to provide accurate and timely information as required by law when information is received that indicates information required by law has not been provided or is not accurate.
Availability Disclaimer:
Malpractice Claims Disclaimer: |
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Name | Colette Valette |
Credential | PSY.0002208 |
Healthcare Profile - Licensed Psychologist Introduction | |||||||||||||
Healthcare Professions Profile | Introduction |
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Please be aware that this profile is only for your LICENSED PSYCHOLOGIST license. Do not provide information for other license types you hold on this profile. You will be required to complete a profile for every license you hold that is included in the profiling requirement. All information provided in this profile must be updated within 30 days of any change of information unless your profession's statute says otherwise, or unless the question specifies otherwise. | |||||||||||||
Healthcare Profile - Location of Practice | |||||||||||||
Healthcare Professions Profile | Location of Practice |
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1. Are you currently practicing in the healthcare profession associated with this profile? | |||||||||||||
No |
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Healthcare Profile - Psychology Education and Training | |||||||||||||
Healthcare Professions Profile | Education and Training |
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3.
School or Education Level:
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Doctorate Degree |
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4.
Please enter the year your initial Degree was achieved: Only enter the year in YYYY format
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1988 |
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Healthcare Profile - Other Licenses | |||||||||||||
Healthcare Professions Profile | Other Licenses |
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5.
Have you ever held, or do you currently hold any other licenses in this profession from any other state, country or province?
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Yes |
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Healthcare Profile - Other Licenses if Yes | |||||||||||||
Healthcare Professions Profile | Other Licenses |
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6.
Other Licenses:
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Healthcare Profile - Board Certifications | |||||||||||||
Healthcare Professions Profile | Board Certifications |
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7.
Do you hold any current Board Certifications?
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No |
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Healthcare Profile - Practice Specialties | |||||||||||||
Healthcare Professions Profile | Practice Specialties |
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9.
Do you have a practice specialty in which you are appropriately trained and actively practicing?
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Yes |
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Healthcare Profile - Psychology Practice Specialties if Yes | |||||||||||||
Healthcare Professions Profile | Practice Specialties |
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10.
Practice Specialties:
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Healthcare Profile - Colorado Hospital Affiliations | |||||||||||||
Healthcare Professions Profile | Colorado Hospital Affiliations |
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11. Do you have a current affiliation or clinical privileges with any Colorado Hospital? | |||||||||||||
No |
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Healthcare Profile - Other Facility and Out of State Hospital Affiliations | |||||||||||||
Healthcare Professions Profile | Other Facility and Out of State Hospital Affiliations |
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13.
Do you have a current affiliation with any healthcare facility or a non-Colorado hospital?
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No |
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Healthcare Profile - Business Ownership | |||||||||||||
Healthcare Professions Profile | Business Ownership |
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15.
Do you have a current business ownership interest in any healthcare-related business?
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No |
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Healthcare Profile - Employer | |||||||||||||
Healthcare Professions Profile | Employer |
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17.
Do you have an employer in the profession in which you are licensed or are applying for a license?
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No |
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Healthcare Profile - Employment Contracts | |||||||||||||
Healthcare Professions Profile | Employment Contracts |
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19.
Do you have a contract with any business whose mission relates to healthcare services or products where the value is greater than $5000 annually?
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No |
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Healthcare Profile - Disciplinary Actions | |||||||||||||
Healthcare Professions Profile | Disciplinary Actions |
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21.
Have you ever had public disciplinary action taken against your license by any board or licensing agency in any state or country?
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Yes |
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Healthcare Profile - Disciplinary Actions if Yes | |||||||||||||
Healthcare Professions Profile | Disciplinary Actions |
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22.
Disciplinary Actions:
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Healthcare Profile - Restrictions and Suspensions | |||||||||||||
Healthcare Professions Profile | Restrictions and Suspensions |
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23.
Have you ever entered into any agreement or stipulation to temporarily cease your practice or had a board order issued restricting or suspending your license?
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No |
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Healthcare Profile - Healthcare Facility Actions | |||||||||||||
Healthcare Professions Profile | Healthcare Facility Actions |
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25.
Since September 1, 1990, have you had any final actions resulting in involuntary limitations or probationary status on or reduction, nonrenewal, denial, revocation or suspension of medical staff membership or clinical privileges at a hospital or healthcare facility? You are not required to report a precautionary or administrative suspension unless you resigned your medical staff membership or clinical privileges while the suspension was pending.
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No |
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Healthcare Profile - Termination of Employment | |||||||||||||
Healthcare Professions Profile | Termination of Employment |
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27.
Have you ever been terminated by an employer for a reason that would be considered a violation of your profession's practice law?
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No |
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Healthcare Profile - Convictions | |||||||||||||
Healthcare Professions Profile | Convictions |
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29.
Since you were issued a license to practice your profession in any state or country, have you had any final criminal conviction(s) or plea arrangement(s) resulting from the commission or alleged commission of a felony or crime of moral turpitude in any jurisdiction?
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No |
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Healthcare Profile - Malpractice Claims | |||||||||||||
Healthcare Professions Profile | Malpractice Claims |
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31.
Since September 1, 1990, have you had any final judgment, entered into a settlement, or paid an arbitration award for malpractice?
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Yes |
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Healthcare Profile - Malpractice Claims if Yes | |||||||||||||
Healthcare Professions Profile | Malpractice Claims |
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32.
Malpractice Claims:
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Healthcare Profile - Malpractice Carrier Refusal | |||||||||||||
Healthcare Professions Profile | Malpractice Carrier Refusal |
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33.
Have you been denied liability insurance, or has your liability insurance coverage been limited, restricted or terminated by the insurance carrier?
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No |
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Healthcare Profile - Optional Narrative | |||||||||||||
Healthcare Professions Profile | Optional Narrative |
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35.
Optional Narrative:
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Key Presenter for National Association of Disability Examiners twice.
Charity/Volunteer/Training staff at orphanages and schools in developing countries: India, Belize, Cozumel. Work at homeless shelters. |
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Healthcare Profile - Attestation | |||||||||||||
Healthcare Professions Profile | Attestation |
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By submitting this Healthcare Professions Profile to the Division of Professions and Occupations you are attesting that:
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36. Submission Date: | |||||||||||||
08/24/2023 |
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Review | |||||||||||||
It's a good idea to print this screen for your records as after you submit your application you will not be able to access it again. To do so follow the below steps:
After you close the Print Review tab, you will be returned to this page and can complete your submission. |
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