Member/Certification Report

Member/Certification Report

This form is for insurance agents, employers or facilities requesting verification of a member/certified counselor. Please click here to process payment. Payment will open in a new window

Member/Certification Verification

$25.00

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  • Please enter the name of the individual you wish to have verified with the CACCF
  • Price:
    A fee of $25.00 Plus applicable taxes is required