2021 Annual ARISE Certification Renewal

Personal Information

* First Name:
* Last Name:
* Email Address:
* Confirm Email Address:
* Address 1:
Address 2:
* City:
State:
ZIP Code:
Country:
Cell Phone:

Fee

Type	Fee
Event fee	$150.00

Business Information

Company:
Job Title:
Phone:
City:
State:
Website:
Country:

Required Questions

The following questions refer to completion of the requirements for maintaining CAI status. You must attest to completing the requirements before a certificate will be issued to you. Please note that all information provided by CAIs is subject to random verification by the ARISE� staff. Any questions about these requirements may be directed to the ARISE� Training Coordinator at training@arise-network.com.
*
I attest that I have completed at least 3 continuing education hours in the past year in topics that include: ethics, addiction, family systems and/or mental health. I understand that for every 3 years I am active as a CAI, I must complete at least 3 continuing education hours in ethics.
- Yes, I attest to the above
- No, I do not attest to the above
*
All CAIs are required to complete a refresher course of the ARISE� Three-Day Continuing Care with Intervention Training (or another approved course) at least once every 3 years while acting as a CAI. If this is my third year acting as a CAI, I attest to having completed a refresher course. (Please contact the ARISE� Training Coordinator with any questions about approved courses and information on completing a refresher remotely).
- Yes, I attest to the above
- No, I do not attest to the above
*
All CAIs are required to hold professional liability insurance ($1 million individual, $3 million aggregate) and to maintain this coverage while acting as a CAI. I attest to having professional liability insurance.
- Yes, I attest to the above
- No, I do not attest to the above.
*
All CAIs are required to be professionally licensed/certified OR members of an organization with a governing body of ethics, such as AIS, NII, NAADAC, APA, or AAMFT. I attest to being either professionally licensed/certified OR a member of an organization with a governing body of ethics.
- Yes, I attest to the above
- No, I do not attest to the above.
* All of us at ARISE� Network truly appreciate our talented CAIs. Please take a moment to let us know how we can better support you and meet your needs. What can we do to make your experience as a CAI more engaging and fulfilling? Feel free to expand on ideas such as events, presentations, problem areas in your practice, etc. THANK YOU!
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If it has been over three years since your last training, we have many options coming up for you to take a refresher both online and in person. You can contact the Training Coordinator at training@arise-network.com or check our website at arise-network.com/arise-training/

ARISE� CAI Database information:

By submitting your information, you agree to be listed in the ARISE� CAI Database as an independent practitioner and take full responsibility for any client you may acquire through our website. The ARISE� CAI Database is a platform for families to find access to CAIs. ARISE� does not ask for any percentage of compensation you receive for your services as a CAI.
Full name (include credentials)
Contact information (City, State, Email address, Phone):
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Please list how far you�re willing to travel and whether that includes air travel as well. ex. Locally, Statewide, National, International.
Are you willing to work virtually?
Are you a licensed clinician/counselor?
Do you have a sliding fee scale?
Brief bio (include any specialty areas in which you have training/experience) 500 words or less.
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I agree to send my headshot to Joyce at training@arise-network.com.
- Yes
- No
I consent to have my email address and phone number listed in the ARISE� CAI Directory:
- Yes
- No

Contact

2021 Annual ARISE Certification Renewal

Personal Information

Fee

Business Information

Required Questions

I attest that I have completed at least 3 continuing education hours in the past year in topics that include: ethics, addiction, family systems and/or mental health. I understand that for every 3 years I am active as a CAI, I must complete at least 3 continuing education hours in ethics.

All CAIs are required to hold professional liability insurance ($1 million individual, $3 million aggregate) and to maintain this coverage while acting as a CAI. I attest to having professional liability insurance.

All CAIs are required to be professionally licensed/certified OR members of an organization with a governing body of ethics, such as AIS, NII, NAADAC, APA, or AAMFT. I attest to being either professionally licensed/certified OR a member of an organization with a governing body of ethics.

ARISE� CAI Database information:

I agree to send my headshot to Joyce at training@arise-network.com.

I consent to have my email address and phone number listed in the ARISE� CAI Directory:

Payment

Payment Method

Payment Summary