Associate Membership - International Psychotherapy Institute

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* For Full Membership please indicate IPI Program and Completion date (or equivalent training): * For Full Membership please indicate IPI Program and Completion date (or equivalent training) is not valid

I certify that there are no past or pending findings of unethical or unprofessional conduct against me or past or pending actions against my clinical license. For the duration of my involvement with IPI, I agree that I will notify IPI if my situation changes in regard to ethical and licensing complaints.: I certify that there are no past or pending findings of unethical or unprofessional conduct against me or past or pending actions against my clinical license. For the duration of my involvement with IPI, I agree that I will notify IPI if my situation changes in regard to ethical and licensing complaints. is not valid

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I understand that I will be hearing clinical material in this course that must be kept strictly confidential, and not discussed or disseminated in any form outside of the course, including via personal recording, photos, or storing of digital content. This means that I need to view the videoconference in a private place where it cannot be overheard or observed. I further understand that although clinical material is heavily disguised, I will leave the session immediately if I feel I recognize the person being presented. I agree to follow the IPI Ethics Code, and any deviation from this would be considered a breach of these ethical principles. I certify that there are no past or pending findings of unethical or unprofessional conduct against me or past or pending actions against my clinical license. For the duration of my involvement with IPI, I agree that I will notify IPI if my situation changes in regard to ethical and licensing complaints. The therapeutic approaches presented and discussed in this course are presented solely for educational purpose of those attending. Participants are responsible for determining the appropriate treatment for particular patients in particular circumstances. As a course participant, I agree that I will indemnify and hold harmless the IPI and its seminar presenter(s), and its officers and directors, for any liability they incur as a result of my participation and/or presentation in the seminar. I understand that this meeting may be recorded by the IPI administration for future use and, accordingly, I give my consent for recording and its repurpose in the future by other professional audiences. I understand I will have the option to turn off my camera and omit my name from my Zoom screen (in my zoom preferences) if I wish to protect my privacy while participating in the learning session.

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Terms: $230 / Year

	Associate Membership – Initial Payment $230 / Year	$230.00
	Total	$230.00

Associate Membership – Initial Payment

$230 / Year

$230.00

Total

$230.00