Home Provider Application

Provider Application

by admin

If you’re interested in becoming a Misophonia provider, please fill out an application. You will hear back shortly.

To Become a Level 1 Misophonia Provider please have the following:

  • accreditation in one of the listed fields
  • attend 1 Misophonia Workshop through www.misophoniaeducation.com. These webinars are hosted by Dr. Jennifer Jo Brout of the IMRN. Please attach proof of attendance to your submission.

Please note we will be changing these guidelines in the future.

Provider Application

Name(Required)
Address(Required)
Please note: this will be displayed publicly.
Please note: this will be displayed publicly.
What type of provider are you?(Required)
If you have two categories, please select both. For example, if you are an educator (professor/teacher), who also counsels. Another example is a Family Therapist who also does general counseling.
What age group do you work with?(Required)
Please check all that apply.
What class did you take?(Required)

If you have not yet taken a course, please view our approved classes.