Retiring Form - Healing Touch Certification

First Name(*)

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Last Name(*)

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Address(*)

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City(*)

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State or Province(*)

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Zip or Postal Code(*)

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Email(*)

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Contact Phone(*)

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Retired status offered by Healing Touch Program for certified practitioners and instructors.(*)

I hereby apply for HTCP-Retired

I hereby apply for HTCI-Retired

I hereby apply for HTCP/I-Retired

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Note: Please fill in the dates ONLY for the certification you are retiring.

Practitioner certification start date

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Practitioner certification end date

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Instructor certification start date

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Instructor certification end date

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I confirm that I have been certified and working with Healing Touch as a practitioner or as an instructor.(*)

By submitting this form I attest that all the information in it is true.

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$35 Certification Retiring Fee

$35 Certification Retiring Fee - 35.00 USD

Total Fee

0.00 USD

Spam check(*)

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Certification Retirement Application