Sexuality Counselor Application

AASECT Sexuality Counselor Application

Use the "Save" button at the bottom of the application and then select "Skip Create an Account" to save and come back to your form as often as needed. Please DO NOT create an account when saving your form, or you will not be able to share the form with your Supervisor for their signature.
If you need assistance completing this form, please click here to complete the Certification Application Feedback/Troubleshooting Form.

You can also contact us at certification@aasect.org.
Review: Sexuality Counselor Requirements
About You
Name*

First NameMiddle Name or initial (optional)Last Name
Other names for me that may appear on my application.

First NameMiddle NameLast Name
Pronouns (optional)
Credentials (optional)
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Telephone*
AASECT membership.*
Certification requirement: I verify that I currently reside or was educated in the United States, Canada, Mexico, or Israel.*

Yes
Code of Conduct
Review: AASECT Code of Conduct for Members
Have you ever been disciplined for professional or ethical misconduct?*

YesNo
Is any action pending against you for professional or ethical misconduct?*

YesNo
If you answered "Yes" to either of the above two questions, please provide more detail here.
I have read and understood the AASECT Code of Conduct for (CoC) for Certified Members. I understand the CoC and I agree to adhere to the CoC. *

Powered by Jotform Sign Clear
Academic Education & Sexuality Counseling Training
Academic Transcript
Please upload the official academic transcript from the last degree that you earned. Your degree must be recognized in the United States, Canada, Mexico, or Israel.*

Cancelof
Comprehensive Training Program
If you completed any comprehensive training programs for sexuality counselors, (all Core Knowledge Areas, and/or all Sex Educator Skills Training Areas), please upload relevant documentation (i.e., transcript or certificate) here. If not, please skip this question.

Cancelof
AASECT CEs
If you are using AASECT sponsored or approved CEs earned from courses, trainings, or AASECT volunteer work (maximum of 5 volunteer credits), please upload certificates here.

Cancelof
Non-AASECT CEs
If you are using non-AASECT sponsored or approved courses or training, please upload documentation (syllabi, course outlines, etc.) from any other additional professional training in Core Knowledge or Sex Educator Skills Training from any relevant, recognized professional organization outside of AASECT (i.e., colleges, professional conferences, APA, AAMFT, NASW, NASPA, ACHA, etc.). Professional CE credit courses and/or trainings will count for one half (1/2) of full AASECT sponsored or approved courses/trainings. Acceptance of coursework is at the discretion of the AASECT Certification Committee member reviewers.

Cancelof
If you did not attend a Comprehensive program, please list the courses in the applicable Core Knowledge Areas below. Of the 90 hours, 15 hours must be live or synchronous.

Please enter one course per line, and click "Save and Add Row" to ensure your information is saved.
A. Ethics and Ethical Behavior
B. Developmental sexuality from a bio-psycho-social perspective across the life course
C. Socio-cultural, familial factors (e.g., ethnicity, culture, religion, spiritualty, socioeconomic status, family values) in relation to sexual values, behaviors
D. Issues related to sexual orientation and/or gender identity: heterosexuality, issues and themes impacting lesbian, gay, bisexual, pansexual, asexual people, gender identity and expression
E. Intimacy skills (e.g., social, emotional, sexual), intimate relationships, interpersonal relationships and family dynamics
F. Diversities in sexual expression and lifestyles, including, but not limited to, polyamory, swinging, BDSM, and tantra
G. Sexual and reproductive anatomy/physiology
H. Health/medical factors that may influence sexuality including, but not limited to, illness, disability, drugs, mental health, conception, pregnancy, childbirth, pregnancy termination, contraception, fertility, HIV/AIDS, sexually transmitted infection, other infections, sexual trauma, injury, and safer sex practices
I. Range of sexual functioning and behavior, from optimal to problematic, including but not limited to common issues, such as: desire discrepancy, lack of desire, difficulty achieving or maintaining arousal, sexual pain, penetration problems, and difficulty with orgasm
J. Sexual exploitation, including sexual abuse, sexual harassment, and sexual assault
K. Cyber sexuality and social media
L. Substance use/abuse and sexuality
M. Pleasure enhancement skills
N. Learning theory and its application
O. Professional communication and personal reflection skills
P. History of the discipline of sex research, theory, education, counseling, and therapy
Q. Principles of sexuality research and research methods
If you did not attend a Comprehensive program, please list the courses in the applicable Sexuality Counseling areas below. Of the 60 hours, 30 hours must be live or synchronous.

Please enter one course per line, and click "Save and Add Row" to ensure your information is saved.
A. Theory and methods of personal/individual counseling
B. Theory and methods of sexuality counseling approaches to specific populations (e.g., youth, older adult, couples, LGBTQ people, people with disabilities, ethnic/cultural/faith-based populations)
C. Theory and methods of different approaches to intervention in relationship systems
D. Theory and methods of decision-making concerning sexually-related medical interventions
E. Ethical issues in sexuality counseling
F. Theory and practice of consultation, collaboration, and referral
Sexuality Attitude Reassessment (SAR)
Please upload your SAR Certificate. SAR certificates must be at least 14 hours/CEs to qualify for initial certification. Specialty SARs may not apply to initial certification. Please check with your SAR provider to make sure that it meets all requirements for initial AASECT Certification. (Note: Prior to Jan 1, 2022, the requirement was 10 hours. You may upload a 10 hour certificate if you began your supervision contract prior to this date.)*

Cancelof
Please upload a comprehensive statement of professional philosophy, and goals of Sexuality Counseling, including how the SAR affected that philosophy (one page is between 450-550 words).*

Cancelof
Clinical Experience, Field Work, Internship, or Professional Training Experience
Certification requirement: I verify that I have had 1000 hours of sexuality counseling experience within the last 5 years and in no less than 2 years.*

Yes
Please upload your current résumé or CV.*

Cancelof
Supervision and Endorsement Forms
Supervision and Endorsement Forms:

Endorsement Form - AASECT Supervisor (Online fillable version)

Endorsement Form - AASECT Supervisor (Downloadable PDF)

Endorsement Form - Professional Colleague (Online fillable version)

Endorsement Form - Professional Colleague (Downloadable PDF)
Primary Supervisor*

First NameLast Name
Primary Supervisor Email*
example@example.com
Please upload your Supervision Endorsement Form and Recommendation Letter from your Primary Supervisor.*

Cancelof
If you had any additional Supervisors, please list their names here.
The documents and endorsement forms can be uploaded below.
Please upload any other endorsement forms and recommendation letters from additional Supervisors.

Cancelof
Please list the names of the two (2) professional colleagues who have provided recommendation letters.*
The letters and endorsement forms will be uploaded below.
Please upload two (2) Professional Colleague Endorsement Forms and recommendation letters.*

Cancelof
Attention Applicant:

Please use the "Save" button at the bottom of the application and then select "Skip Create an Account" to get a shareable link that can be used to send your application to your Primary Supervisor for their review and signature. Please DO NOT create an account when saving the form, or you will not be able to share the form with your Supervisor for their signature.
Supervisor Signature
Primary Supervisor*

First NameLast Name
Primary Supervisor Signature: "I have reviewed and approved this application for AASECT Certification."*

Powered by Jotform Sign Clear
Attention Supervisor:

Please use the "Save" button at the bottom of the application and then select "Skip Create an Account" to get a shareable link that can be used to send the application back to your Supervisee for their signature and submission. Please DO NOT create an account when saving the form, or you will not be able to share the form with your Supervisee.
Signature and Submission
In signing this application, I attest that: 1. All pages of the application form are completed in English. 2. All endorsement forms, transcripts and other relevant supporting documentation are attached in the appropriate areas 3. I agree to pay the non-refundable application fee of $300.00 (payment instructions will be sent by email from the AASECT Certification Staff once this application is received). *

Powered by Jotform Sign Clear
Date*

MonthDayYear
Date
Should be Empty:

AASECT Sexuality Counselor Application

About You

Code of Conduct

Academic Education & Sexuality Counseling Training

Academic Transcript

Comprehensive Training Program

AASECT CEs

Non-AASECT CEs

If you did not attend a Comprehensive program, please list the courses in the applicable Core Knowledge Areas below. Of the 90 hours, 15 hours must be live or synchronous.

If you did not attend a Comprehensive program, please list the courses in the applicable Sexuality Counseling areas below. Of the 60 hours, 30 hours must be live or synchronous.

Sexuality Attitude Reassessment (SAR)

Clinical Experience, Field Work, Internship, or Professional Training Experience

Supervision and Endorsement Forms

Attention Applicant:

Supervisor Signature

Attention Supervisor:

Signature and Submission