APPLY TO CERTIFY 2026

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First Name

Last Name

Preferred phone

Complete Mailing Address

Preferred email

Which NBCCH-approved 50+ hour Clinical Hypnotherapy course did you complete?

WHEN did you take your qualifying hypnotherapy training?

Please provide ALL required information about your health-related license/s.

Malpractice policy information

If you work for the VA, please provide your VA email for confirmation only.

For which Certification level are you applying? *

Certified Clinical Hypnotherapist (NBCCH)

Diplomate of Hypnotherapy (NBCDCH)

Fellow of Hypnotherapy (NBCFCH)

Certified Hypnotist (NBCHt) - no license

Which one do you prefer? *

Just send me a plain paper version of my certificate. I plan to file it.

Please send my frameable parchment and foil certificate.

PLEASE provide your name, academic degrees, and state licenses.

Describe your fee status:

I am US enlisted or a veteran. (Skip payment.)

I only treat veterans and enlisted. (Skip payment.)

I treat enlisted, veterans, and supplement my practice by seeing civilians. (Please pay the small certification fee).

I treat a civilian clientele (Please pay the certification fee).

Alternate name under which your payment might be located

I affirm that I have not been convicted of a felony, that the information I have provided is accurate, and that I will comply with NBCCH regulations.

CONTACT NBCCH HERE

or call/text to 310.703.7449

Certificants whose information and fees are current may

copy this logo for use on their professional materials.

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