Requirements to obtain an IM Exception to IP Certification:

1. Please be sure you have passed the written, practical, and visual exams BEFORE applying for an exception to certification.
2. Please note that applicants MUST respond affirmatively to questions #4, #5, #6 and provide a reference from an IM Master Instructor in question #7.

Applications are processed within 30 days.
Asterisk denotes required answer.

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* 1. Please enter date

Date

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* 2. Please enter your name

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* 3. Please identify your profession:

You must answer affirmative for each Question #4, #5, #6, in order to be certified for an Exception to IM IP and proceed to the next question.

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* 4. Please confirm that:
(1 point)

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* 5. Please confirm that: Yes, I have successfully passed the IM written, practical, and visual exams AND the exams were administered by an instructor certified in the relevant track.
(1 point)

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* 6. Have you completed at least one CPoCUS/non-CPoCUS accredited IM POCUS course as a participant? A minimum of one course / Fellowship is required.
(1 point)

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* 7. Please provide a short reference from an IM Master Instructor. (1 point)

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* 8. Attach additional material (if applicable).

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 9. Attach additional material (if applicable).

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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