RIM Certified Facilitator Renewal

Thank you for renewing your Certification through the RIM® Institute. Please complete the form no later than Friday, February 9th.

Name

First NameLast Name

I have facilitated at least 4-5 RIM® sessions per year:*

YesNo

I have maintained a relationship with The RIM® Institute by participating in at least one of these activities: (Check all that apply)

Attended a RIM® Retreat, RIM® reunion or eventPresented to other RIM® Facilitators content that will enhance RIM® successIntroduced RIM® to potential Clients, other professionals or lay groupsOffered ProBono sessions for RIM® Facilitator students and low-income clients at the request of The RIM® Institute

I have continued my RIM® education through completion of one of the following over the last year. (Check all that apply)

Attended or listened to 2 monthly Facilitator phone calls in the last yearRetook 1 RIM® Essentials or other class in last yearAssisted in 1 RIM® Intensive Retreat in the last yearReceived at least 1 personal RIM® session in the last year

I understand that as a Certified RIM® Facilitator, (please check all)*

I can call myself a RIM® Facilitator under my own company name and logo separate from The RIM® InstituteI can do one-on-one and group RIM® sessions with the agreement that I call it RIM® with the client or group.I can reference my training under Dr. Deborah Sandella and The RIM® InstituteI am NOT allowed to Use Dr. Deborah Sandella's name, the RIM® Institute Name, the title or subtitle of any RIM® Seminar, Workshop, or Retreat, RIM® class materials or any derivative form of the above in any other context without written permission from the RIM® Institute or without separate Permission or licensing agreement (except in reference to my training or quotes).I am NOT allowed to teach the RIM® process without additional RIM® Institute training and a licensing agreement.

I have and will maintain the RIM® Code of Ethical Standards*

YesNo

RIM® Code of Conduct: As a professional RIM® Facilitator, I agree to: (please check all)*

Maintain client confidentialityInteract and communicate with clients and colleagues in a respectable, professional mannerKeep my word and agreementsScreen out mentally ill and suicidal clients and get them safely to appropriate resourcesPractice within my area of expertiseMaintain healthy interpersonal and physical boundaries with clientsContinue to pursue my own personal growth through individual practices and outside resources.That the RIM® Certification Program trained me as a Professional RIM® Facilitator and not as a psychotherapist, counselor or coach.

Current E-mail*

example@example.com

Phone Number*

Area CodePhone Number

Locale (City and State required--only list street address if offering in-person sessions)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

If you operate remotely, list modes of communication (Phone, Zoom, Skype, etc.).

Current Website url

The following 7 questions are regarding the information on your RIM® Institute Certified Facilitator listing on the RIM®Institute Facilitator directory. If left blank, the listing will remain the same. Do you want to change your listing on The RIM® Institute page?*

Yes, I'd like to add my listing or make some changesPlease leave my listing the samePlease remove my listingI choose to remain unlisted

Do you work with trauma?*

YesNo

Types of RIM® sessions you offer (individual, group, coaching, business etc.) If blank, original listing will be kept the same.

List all populations you work with (adults, teens, children, business, other.) If blank, original listing will be kept the same.

Your current specialty. If blank, original listing will be kept the same.

Brief Bio. If blank, original listing will be kept the same.

Personal philosophy (4-5 sentences). If blank, original listing will be kept the same.

Updated photo if desired. (.jpg file)

Browse Files

I will pay the 1-year administrative renewal fee of $75 (if no, uncheck blue box under "my products", below)*

YesNo

Completion of the above requirements renews your Certification status as a RIM® Facilitator, which includes an optional listing in the Directory of Certified RIM® Facilitators on the website and your own personal page.

We value you! Please contact The RIM® Institute if you would like to find more ways to be involved in the RIM® community, retake classes at a discount, or continue your RIM® training.

PLEASE SELECT TO PAY WITH PAYPAL ONLY

VENMO TAB DOES NOT CURRENTLY WORK (but for some reason cannot be removed) :) Thank you!

My Products

Annual Certification Renewal$75.00

Total $0.00

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RIM® Facilitator Renewal