Apply for Full Membership

To apply for Full membership, submit your completed application along with the required supporting documents. We will review your application and notify you when you are approved, at which time your $250 yearly membership fee will be due. Once paid, you will have access to the members-only portion of our website.

We never share a member’s private information so, for purposes of communication and record-keeping, we would appreciate it if you share all contact information requested.

Before submitting your application, please review our Terms of Service.
Specifically, please note that sharing member forum posts or other members-only information outside of ISEAI (via email, social media, etc) is not allowed. Please review the Forum Rules and Etiquette Guidelines. Additionally, please note that all members must agree to practice within the scope of service appropriate to their education, training and licensure, including any applicable board or state regulation. Communication within the forum must stay within the member’s scope of practice. ISEAI education is meant to enhance knowledge and understanding of environmentally-driven illness but does not expand any member’s legal scope of practice.

Note: When your membership is approved you will be asked to pay your initial one-time yearly membership dues via Stripe or PayPal. You will be sent an email reminder one month (and one week) prior to your yearly membership renewal date. Each year you will be given the option to renew your membership, and you can control your settings by logging in to iseai.org and using the My Account page (Members tab). Please make sure your credit card information is up to date.

Step 1:

Provide Supporting Documents:

• Fill in the ‘State/territory you practice in, and license/certification number (if applicable)’ field further below.
• Fill in the ‘LinkedIn Profile URL’ field further below, or email your CV (please highlight your EAI experience if possible)

This information is required in order for the Membership Committee to review your application – however, you may also submit the application and provide the information at your convenience by email – membership (at) iseai.org

Step 2: Apply

Price:

Free

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

-- Select Country -- United States (US) Afghanistan Åland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belau Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba CuraÇao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Republic of Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Martin (Dutch part) Saint Pierre and Miquelon Saint Vincent and the Grenadines San Marino São Tomé and Príncipe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (UK) Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Western Samoa Yemen Zambia Zimbabwe

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Primary profession applying under:* Primary profession applying under is Required

State/territory you practice in, and license/certification number (if applicable, can list multiple): State/territory you practice in, and license/certification number (if applicable, can list multiple) is not valid

If you are licensed, please list the issuing body who governs your licensure.: If you are licensed, please list the issuing body who governs your licensure. is not valid

LinkedIn Profile URL: LinkedIn Profile URL is not valid

Personal Phone:* Personal Phone is Required

Office Full Address (for directory listing, if applicable):: Office Full Address (for directory listing, if applicable): is not valid

Office Phone (for directory listing, if applicable):* Office Phone (for directory listing, if applicable) is Required

Office Email (for directory listing, if applicable):* Office Email (for directory listing, if applicable) is Required

Website URL (for directory listing, if applicable): Website URL (for directory listing, if applicable) is not valid

Office Information: Office Information is not valid

Accepts Insurance Accepts Medicare Accepts Medicaid Superbill Only Consultations Online Consultations by Phone

Highest level of education:* Highest level of education is Required

--------------------High school degreeSome college, no degreeAssociate degreeBachelor's degreeMaster's degreeProfessional degreeDoctorate

Are you actively practicing in the field of environmentally acquired illness (EAI)? If yes, for how long?:* Are you actively practicing in the field of environmentally acquired illness (EAI)? If yes, for how long? is Required

Please list any EAI-related training or certification: ADAPT (Kresser), Bredesen, CIRS, IFM, ILADEF/ILADS, etc - provide specifics if needed:* Please list any EAI-related training or certification: ADAPT (Kresser), Bredesen, CIRS, IFM, ILADEF/ILADS, etc - provide specifics if needed is Required

In addition to above, who are the most influential teacher(s) or institution(s) you have been affiliated with in the EAI field? Please tell us about your association with them.:* In addition to above, who are the most influential teacher(s) or institution(s) you have been affiliated with in the EAI field? Please tell us about your association with them. is Required

Please provide any other information about your professional experience in the EAI field, personal interests in EAI (if any), and any other background information you wish to share:* Please provide any other information about your professional experience in the EAI field, personal interests in EAI (if any), and any other background information you wish to share is Required

Do you currently carry prescriptive rights in the state/territory you actively practice in?: Do you currently carry prescriptive rights in the state/territory you actively practice in? is not valid

--------------------Full prescriptive rightsFull prescriptive rights by agreement/supervisionPartial prescriptive rightsPartial prescriptive rights by agreement/supervisionNo prescriptive rightsOther

Prescriptive rights details: Prescriptive rights details is not valid

If your prescriptive rights (full or partial) are via agreement/supervision please provide the supervising clinician's name, profession, city/state of practice and license number. If you have partial prescriptive rights please describe inclusions and limitations; be specific.

If practicing outside of the US, please describe the scope and details of your prescriptive rights: If practicing outside of the US, please describe the scope and details of your prescriptive rights is not valid

General educational/professional experience:* General educational/professional experience is Required

Other areas of special interest/expertise:* Other areas of special interest/expertise is Required

Statement of medical or health professional board action(s): Statement of medical or health professional board action(s) is not valid

Malpractice history: Malpractice history is not valid

Willingness to participate on committees or projects set up by the Board:* Willingness to participate on committees or projects set up by the Board is Required

--------------------YesNo

Inclusion on internal referral list?:* Inclusion on internal referral list? is Required

--------------------YesNo

Facebook Username and/or Profile URL: Facebook Username and/or Profile URL is not valid

Instagram Profile URL: Instagram Profile URL is not valid

Twitter Handle: Twitter Handle is not valid

Is there someone we can thank for your referral? Are they an ISEAI Member?: Is there someone we can thank for your referral? Are they an ISEAI Member? is not valid

If not, how did you hear about ISEAI?: If not, how did you hear about ISEAI? is not valid

Promo Code: Promo Code is not valid

Describe your professional scope of practice:* Describe your professional scope of practice is Required

Agree to operate solely within my professional scope of practice while interacting on the ISEAI Forum and during Webinars and Conferences*

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength  Password must be "Strong" or stronger

*

I have read and agree to the Terms Of Service.*

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