• 120 Day Extension Request Form

    Fee - $50
  • Please note - 120 days is the MAXIMUM amount of time your certification can be extended during a re-certification period. 

    If you are currently on a 30 day extension, and request a 120 day extension, you will only have 90 days added to your extension - However, the 120 day extension is permanent (meaning when you re-certify, you will receive 2 years from your extended expiration date / this is not the case with the free 30 day extension).

     

    Candidate Status cannot be extended through this form. If you are trying to extend your Candidate Status, please see https://mhacbo.org/en/forms-info/faq/

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