APPLY FOR CERTIFICATION

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 this required information about your health-related license

Malpractice policy information

Please check this box if you are a US Veteran or Enlisted, or if you work EXCLUSIVELY with Veterans or Enlisted. Thank you for your service.

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 PDF 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.

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.

SUCCESS.

Please allow 3 weeks for processing.

NOW GO TO THE PAYMENT TAB TO COMPLETE YOUR APPLICATION.

Except Vets and therapists who work solely with Vets and Enlisted.