Qualifications Review Request Form

Thank you for your interest in the American Institute of Health Care Professionals, Inc.

We are happy to review your educational qualifications to see if they meet our prerequisite requirements for our certification program. When completed, please be sure to “click” the submit button below. Once received, we will review your qualifications and get back to you in 5-7 business days. Please note that you must supply an email address in order for us to process your request.

 

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Name*
Email*
Certification Program(s)
Please tell us the Certification Program(s) you are interested in taking with AIHCP.

Credentials

Provide us with your qualifications for review in the fields below.
Please list any current Professional Licenses. Include the full title and which state it is issued from.
Please list ALL college degrees held and the university/colleges that awarded the degrees.
Please list any certifications you currently hold.
Provide any information that you feel would be helpful to us in making a determination if you meet one of the prerequisites for entering the Certification Specialty Program that you indicated on the top of this form; or that you might be considered based on a close match of prerequisites as defined for the Certification Specialty on our website.
Drop files here or
Accepted file types: png, jpg, pdf, doc, docx, Max. file size: 5 MB, Max. files: 5.
    You may attach documents related to your qualifications.