Certification Application Form

Personal Information

Type your name as you'd like it to appear on the Certificate. If the same as above, please leave this field blank.
Full Address with City, State, ZIP Code and Country.
Accepted file types: .JPG, .JPEG, .PDF
Any kind of license that certifies that you can practice acupuncture.
Accepted file types: .JPG, .JPEG, .PDF

Case Studies

Upload a single .zip file with all your case studies or individual files (up to 8)
Accepted file types: .DOC, .DOCX, .PDF, .ZIP, .RAR