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Application for Certification / Recertification

Experience the Matheson Difference where Experience is the Difference!

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Personal Infomation

Your Email

First Name

Last Name

Degree

Postgraduate Institution

Years

Field

Statement of Professional Institution

I hereby agree that the Evaluation services that I provide will be performed in a manner that is consistent with the highest standards of current practice. I certify that the evaluations that I conduct will be safe, reliable, valid, practical, and will provide utility. I further assert that I recognize the interdisciplinary nature of Evaluation and will participate with other team members in a supportive and cooperative manner. I understand that violation of any of these precepts will be sufficient cause for the revocation of my certification by Matheson Education and Training Solutions.

Type Full Name Here

Check off this box to agree to abide by the professional practice statement that is shown above.

Personal References

Please provide the Name, phone number and/or email address for three (3) individuals who have requested evaluation services from you.

Reference 1 Name

Reference 1 Phone and/or Email

Reference 2 Name

Reference 2 Phone and/or Email

Reference 3 Name

Reference 3 Phone and/or Email

Report Submission Form

Please list ten (10) evaluations that you have performed within the parameters of the Policies and Procedures.

DO NOT PUT ANY PATIENT IDENTIFYING INFORMATION ON THIS LIST

Date of Evaluation (mm/dd/yy) & Diagnosis

Report 1

Report 2

Report 3

Report 4

Report 5

Report 6

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Education and Training Online

Prevention and Wellness

Prevention and Wellness is just one of the Training Tracks available under the Matheson umbrella of courses for health care and ancillary health professionals.

Evalutions

Capacity evaluation has grown internationally and is a versatile skill and service in various areas of Occupational Rehabilitation and will enhance your skills as an evaluator but as a clinician.

Return to Work

When work hardening and work conditioning performed at a high level with measurable results leads to case resolution helping those participating to move forward and reduce the cost of claims.

Mastery Series

Ready to build on university-level training? Our lineup of specialized and advanced training offers the same unrivaled level of quality and support you may already have experienced in our introductory courses.

Certification

At Matheson we view certification and the associated designation as something to be earned through the development of skills and the mastery of processes and documentation.