CNS Directory Application
If you would like to have your information listed on The Neuro Specialist Institute’s
Certified Neuro Specialist (CNS) Directory, please complete the form.
Only complete the sections you would like to have posted on the Directory.
You will be added to the directory after we have verified your certification date.
If you would like to update or remove information on the CNS Directory, please contact The Neuro Specialist Institute at
. The Neuro Specialist Institute will not sell, rent, or lease your personal information to third parties.
I give permission to the Neuro Specialist Institute to post the above information on the Certified Neuro Specialist (CNS) Directory. I understand that this process is voluntarily, and I have the right to remove my information from the Directory at any time.
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This form was created inside of The Neuro Specialist Institute.