International Certification Order Form

Since 1981, the International Certification & Reciprocity Consortium (IC&RC) has protected the public by establishing standards and facilitating reciprocity for the credentialing and licensing of addiction-related professionals through its affiliate boards.

Affiliated boards use IC&RC standards and exams to credential prevention, treatment, and recovery professionals on a reciprocal level. Earning a reciprocal-level certification or license through an affiliate board entitles professionals to purchase an International Certificate to signify the reciprocal status of their jurisdictionally specific credential or license. To purchase an International Certificate, professionals must first hold a valid and current reciprocal-level credential or license through an IC&RC affiliated boards.

IC&RC offers the following International Certificates:

Internationally Certified Alcohol and Drug Counselor (ICADC)
Internationally Certified Advanced Alcohol and Drug Counselor (ICAADC)
Internationally Certified Clinical Supervisor (ICCS)
Internationally Certified Prevention Specialist (ICPS)
Internationally Certified Criminal Justice Addictions Professional (ICCJP)
Internationally Certified Co-Occurring Disorders Professional (ICCDP)
Internationally Certified Co-Occurring Disorders Professional Diplomate (ICCDPD)
Internationally Certified Peer Recovery (ICPR)

An International Certificate is directly tied to a professional’s certification or license with their jurisdictional board. They are not free-standing certificates and International Certificates will be issued to professionals using the same expiration date used by his or her local board for the corresponding credential or license. Professionals should contact their IC&RC affiliate board to determine the equivalency of their credential or license. The contact information for all affiliated boards can be found online at: www.internationalcredentialing.org.

Instructions

Confirm your eligibility for an International Certificate with your local board.
Complete this form and return it with a copy of your board specific certificate that deems you to be eligible for the corresponding International Certificate.
If you are unsure of the IC&RC certificate for which you are eligible, please contact the affiliated board in your jurisdiction. IC&RC will not be able to determine the certificate equivalency. All information will be verified with your local board. Requests with incomplete or inaccurate information will not be processed.

Name*

First NameMiddle NameLast NameSuffix

E-mail*

Phone Number*

Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

IC&RC member board*

Texas Certification Board of Addiction Professionals (TCBAP)

Holding an LCDC alone in the state of Texas does not make one eligible for an IC&RC certificate. Professionals must also hold a credential from TCBAP. A list of all TCBAP credentials can be found on their website at http://www.tcbap.org/?page=47.

If you only hold an LCDC, please contact TCBAP before submitting this form.

Certificates Requested*

ICADC$30.00

ICAADC$30.00

ICCS$30.00

ICPS$30.00

ICCJP$30.00

ICCDP$30.00

ICCDPD$30.00

ICPR$30.00

Total $0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Upload copy of board specific certificate that deems you eligible for the corresponding International Certificate. *

Upload a File

Due to state specific policies and procedures, IC&RC is unable to provide International Certificates for your jurisdiction. Please contact the IC&RC member board in your jurisdiction to request an International Certificate. Contact information for all IC&RC member boards can be found at this link: http://www.internationalcredentialing.org/memberboards.