Membership

Membership in NYSEPH is open to all those who are interested in hypnosis. The Membership fee is $75.00 per year, which runs for the calendar year (membership is free for current NYSEPH students). To join NYSEPH or to renew your membership, please fill out the form below. The link to pay via PayPal is below.

First Name *
Last Name *
Email *
Address
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Primary Phone *
Alternate Phone
Degrees
License #
Hypnosis Training and Experience
Primary Affiliation: Private Practice/Agency
Is there anything else you would like us to know?
How did you hear about NYSEPH? Select all that apply
Website Journal Ad Recommendation Other
Payments $75/yr *
Pay via PayPal
URL

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Optional listing on Website Referral Page

Those who have graduated from NYSEPH and are currently licensed professionals with liability insurance may be listed as a referral on our website. Please provide the information below if you meet these criteria and would like to be listed on the website.

Please enter all information exactly as you would like it to be listed on the website.

First Name *
Last Name *
Email *
Are you a NYSEPH graduate? *
Yes No
If so what year did you graduate?
Are you a licensed health/mental health professional? *
Yes No
Do you carry liability insurance?
Yes No
Required Documents for Referral Listing
- A. Copy of license
- B. Copy of liability insurance
- You may upload scanned documents below or mail paper copies to:
- NYSEPH PO Box 462, New York, NY, 10024
Upload Copy of LicenseAccepted file types: jpeg, pdf, txt
Upload Copy of Liability InsuranceAccepted file types: jpeg, pdf, txt
Required Documents for Referral Listing
A. License Fielde.g., social work, counseling, psychology, etc.
B. License State
C. License Number
Upload Copy of Liability Insurance *Accepted file types: jpeg, pdf, txt

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This box is for spam protection - please leave it blank:

Membership

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Optional listing on Website Referral Page

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