Certificate Request – IANM Medicine

To order a new DIANM certificate please complete the following information. To complete the order of $70 (USD) click on the payment link below.

Date Board Ceritifed(Required)

Name of Board(Required)

Name how you wish it to be displayed(Required)

Do you have a Masters or PhD?

Masters

PhD

Do you have a health care terminal degree other than DC?(Required)

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If the Academy needs to contact you, preferred phone.(Required)

The certificates are beautiful and will come in a large flat mailing envelope. It will take 2-4 weeks to get the certificate.

Fee

Price:

Credit Card(Required)

Cardholder Name

Card Details