Clinical Hours Verification Form | Neonatal Touch and Massage Certification

Please complete this form to validate the Neonatal Touch & Massage Certification Applicant has completed a minimum of 1000 hours of direct neonatal patient care in the NICU/SCN. You can also copy and send this link https://www.neonatalcertification.com/clinical-hours-verification/ to your supervisor or co-worker for them to complete the form.

If you have any questions, please contact us at 1-855-CTC-NTMC or info@infantdriven.com

Name of Neonatal Touch & Massage Certification Applicant*

First Last

Profession

Verification*

I confirm to the best of my knowledge that the above named individual has completed a minimum of 1000 hours of neonatal caregiving in the Neonatal Intensive Care Unit or Special Care Unit.

Name*

First Last

Profession*

Relationship*

Email Address*

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