Visceral Manipulation Certification Application

Visceral Manipulation Certification through the Barral Institute is much more than a credential. The VM Certification credential establishes you as a dedicated professional with the knowledge and skills to uphold high standards of excellence. VM Certification increases your networking and referral status, as your colleagues and potential clients see your commitment to excellence.

You can fill out the form below or download a PDF version of the application.

Please review our privacy policy for further information regarding the submission of your personal information.

Full Name:
Professional Title:
Address Line 1:
Address Line 2:
Work Phone #:
Home Phone #:
Cell Phone #:
Email Address:

Education (include basic post-high school preparation through highest degree held):
Institution (Name, State)	Degree, Diploma, Certificate	Award Year

Current governmental issuance granted:
Professional Licenses / Certifications	Issued By	Number	Date Issued	Expiration

Year Practice Began:

I have completed the pre-requisites and am applying and registering for:

	Techniques Certification Level
	Diplomate Certification Level

	I understand that Visceral Manipulation Certification through the Barral Institute is certifies a person's abilities in Visceral Manipulation (VM). Since certification does not provide a legal right to practice, a person must have the appropriate credential and/or license to practice manual therapy in their locale.

Click here for Frequently Asked Questions About Certification

The Barral Institute
8380 Woodsmuir Drive
West Palm Beach, FL 33412
1.866.522.7725