BC-HIS Designation Misuse Report

BC-HIS Designation Misuse Report
Please use this form to alert NBC-HIS if someone who is not board certified claims to be board certified. NBC-HIS will investigate and respond accordingly. The BC-HIS designation is reserved for board certificants in good standing. To confirm if someone is board certified, please visit our provider listing page here.
Your Name:

First NameLast Name
Your Email Address:
example@example.com
Name of the person incorrectly using the BC-HIS designation:

First NameLast Name
Company information for the person incorrectly using the BC-HIS designation:
Location (address if available, city, state, etc.) of the person incorrectly using the BC-HIS designation:
Where/how did you see the incorrect use of the BC-HIS designation?
Please provide as many specifics as possible -- advertising, flyers, office signage, business cards, social media, etc.
Provide provide any other information you think it is important for us to know.
Document Upload: Please upload pictures of any materials where the designation is being used by someone who should not be using it.

Cancelof
Do you know how we can contact this person?
Should be Empty: