Certification Application – AiRM – Artificial Intimacy Recovery

AIRM^® Certification Application Form

Apply for your Artificial Intimacy Recovery Model^® certification. Choose between initial certification or recertification based on your current status.

Initial Certification Application

Complete your first AIRM^® certification. All fields are required.

Personal Information

First Name

Last Name

Email Address

Phone Number

Professional License Information

License Number

License Type

License State

License Expiry Date

Training Certificates

Level 1 CE Certificate

Level 2 CE Certificate

Supervision Verification

Verification of Supervision Hours

Supervisor Information

*Certification Fee - $150 (Payment will be processed after application review. You will receive an invoice via email)

Application Review Process

Applications will be reviewed within 5-7 business days. You will be notified via email from the AIRM^® team when your certification has been approved. Please ensure your email address is correct and check your spam folder for communications.